Have you ever heard of Shigella flexneri? If you haven’t, you’re not alone. This is one of the less prominent sexually transmitted diseases (STDs) but unfortunately, Shigella flexneri has started gaining some speed lately.

What has been going on and what are the best ways to protect yourself? Just like in the case of preventing other STDs, responsible behaviour on your behalf is one of the biggest essentials.

An Overview of Shigella Flexneri

Shigella flexneri is a bacterium that can cause an infection among humans known as shigellosis. In fact, several bacteria in the Shigella family can contribute to the infection and some of these strains can be transmitted through sexual contact.

The bacterium is concentrated predominantly in faeces. Direct contact with contaminated stool makes it very easy for Shigella to spread from one person to another. The signs of shigellosis begin one or two days after the contact.

Some of the most common symptoms of shigellosis include diarrhoea, stool containing blood or a lot of mucus, abdominal pain, cramps and fever.

It’s possible for some people to get infected without experiencing any symptoms. Still, the faeces of such people contain the bacteria and they will be contagious for up to two weeks after becoming infected.

Shigellosis is typically not a life threatening condition and it will run its course in a couple of days. Most people will not need medications apart from electrolytes to prevent dehydration.  In some severe cases, antibiotics could be prescribed to kill off the bacteria.

A couple of complications are possible for people who have shigellosis. The first and the most obvious threat is extreme dehydration. Other potential complications include haemolytic uremic syndrome (a rare complication characterised by a low red blood cell count), toxic megacolon, reactive arthritis and seizures.

Shigella Flexneri as an STD

Shigella was recognised as a potential STD cause back in the 1970s.

Until then, shigellosis was most common among young children (due to their proclivity to put everything in their mouths) and among communities deprived of access to fresh and clean water.

In 1970, researchers in the US registered a massive shigellosis outbreak among men having sex with men. Anilingus or rimming was seen as one of the primary contributing factors. Digital anal sex using sex toys was also established as an activity bound to increase the risk of infection.

By the 1980s, shigellosis rates increased among adult US males. This was an interesting development as the country registered a reduction in the infection rates among kids due to better understanding of how the bacterium is passed and enhanced personal hygiene recommendations.

Another re-emergence of Shigella flexneri as a STD was registered between 2004 and 2015 among men in the US and the UK. The high infection rates were registered amid a rapid decline of shigellosis among children and women.

Over the past five years, another problem was added to the list. The bacteria from the Shigella family started demonstrating growing resistance towards some of the commonly used antibiotics.

A study was published in 2019, showing that Shigella flexneri has become largely resistant to azithromycin and ciprofloxacin. Due to these findings, the CDC in the US and the World Health Organization (WHO) declared Shigella flexneri a big health risk.

The study collected Shigella flexneri samples among Australians in the period from January 1, 2016 to March, 2018. Of the samples, 50.6 per cent demonstrated azithromycin resistance and 17.6 per cent were resistant to ciprofloxacin. Of all the samples, 92.4 per cent demonstrated some form of reduced susceptibility to the most common antibiotics used in the treatment of such bacterial infections.

Protecting Yourself and the People You Love

Do understand the fact that Shigella flexneri is highly infectious. The disease can cause violent bouts of diarrhoea. While not life-threatening in the vast majority of cases, such an infection can be truly debilitating and linked to a lengthy recovery period. Hence, protecting yourself is vitally important.

The growing drug resistance of the bacterium is an added cause of concern. It means that some of the more difficult cases become even more challenging, even impossible to treat with common medications.

Stellar hygiene is one of the first and probably the most important line of defence.

Do wash your hands and the same applies to the produce you consume (especially leafy greens and other items eaten raw).

When it comes to sex and safe practices, barrier contraception like condoms is the biggest essential. It’s vital if you’re engaging in vaginal intercourse and even more important in the event of anal penetration.

Safe practices aim to reduce the risk of faecal particles passing from one partner to the mouth of the other.  Thus, you should refrain from sexual activity with a person that has been diagnosed with shigellosis or someone who has experienced severe diarrhoea recently.

If you do practice all of these safe steps and you still get infected with shigellosis, don’t panic. Most people will overcome the infection on their own, as unpleasant as it is. Do your best to keep yourself hydrated and wash your hands after each visit to the bathroom, before having a meal and after.

It’s best to refrain from preparing food at these times and to either have a family member cook for you or order professionally-prepared meals.  You should also refrain from sexual contact with a partner for at least two weeks after getting better. As already mentioned, a person can be free from symptoms and they could still carry the bacterium.

As you can see, brand new STDs are starting to emerge. STD infections that were rare previously are now spreading quickly. It’s up to you to protect yourself and the people you love. Sex in a committed monogamous relationship, the use of condoms and regular STD testing for all sexually active individuals can save lives and prevent the spread of disease.

Shim Clinic is here to support and inform you, helping you increase your awareness about STDs. Do not hesitate to contact us if you have questions about some rare or new sexually transmitted diseases.