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Shigella in MSM

What is shigella?

Shigella is a bacteria that can cause severe stomach upset.

How do I get shigella?

The shigella bug is passed on through infected faeces (poo). This can happen through contaminated food or sexual activity.

Sexually transmitted shigella is usually seen in MSM when it is picked up by the bacteria getting into the mouth during sex or via unwashed hands.

Sexual activity that may involve contact with faeces (poo) is a risk e.g. anal sex, fisting, rimming, oral sex or handling a condom or sex toy used for anal sex.

Only a very small amount of the bacteria is needed to cause infection.

Someone with shigella can be infectious for up to a month.

You cannot catch shigella from:

  • kissing or hugging
  • sharing dishes or glasses
  • casual contact (such as at work)

How common is shigella?

The number of cases of sexually transmitted shigella has increased in MSM in the recent past in Europe, including in Ireland.

What symptoms would I have with shigella?

Symptoms often develop around one to three days after (sexual) contact, and last up to a week.

Symptoms may include:

  • diarrhoea - this can be severe and last for a few days
  • feeling sick (nausea) and vomiting
  • stomach cramps
  • feeling feverish
  • in serious cases, diarrhoea that can contain blood and/or mucus

How can I be tested for shigella?

Shigella is usually diagnosed by sending a stool (poo) sample to the laboratory for testing.

If you suspect you have shigella, you should attend your GP who can organise this test.

If you picked up shigella sexually, we recommend that you have routine tests for all sexually transmitted infections (STIs), including chlamydia, gonorrhoea, syphilis, hepatitis B and HIV.

What about my partner?

You should inform your partner about your infection. Your partner is also recommended to have routine tests for all STIs, including chlamydia, gonorrhoea, syphilis, hepatitis B and HIV.

If your partner has symptoms of shigella infection, they should seek immediate medical attention.

Can shigella be treated?

Some forms of shigella do not require any treatment, but the more severe forms will require treatment with antibiotics.

Diarrhoea caused by shigella usually goes away within 5 to 7 days. People with mild infection will generally get better with fluids and rest.

Antibiotics are usually used to help reduce the spread of shigella to someone else and for more severe cases. Some types of shigella can be difficult to treat and sometimes people need to be admitted to hospital for treatment.

Can I infect my partner or others?

You may be infectious for up to a month, so wash your hands with soap and warm water after using the toilet and before touching food.

Basic hygiene: wash your hands after using the toilet!

Do not share towels; avoid using health spas, jacuzzis, hot tubs or swimming pools.

If you work in the food industry, healthcare or childcare settings, you need to stay out of work while you have symptoms. You cannot go back to work until a health professional says so.

When can I have sex again?

If you have diarrhoea, stomach cramps or fever, avoid sex with another person until you get the all clear.

You may be asked to return for a repeat test to make sure the infection has gone. If you are asked to return for a repeat test, we recommend that you don't have sex until you get the repeat test results to confirm that you have cleared the infection.

How can I prevent myself from getting shigella?

You can lower your risk of getting shigella during sex by:

  • washing hands (buttocks, groin and penis too, ideally) or showering before and after sex
  • avoiding licking the skin on the buttocks, around the backside or groin, as they may carry the bacteria
  • changing condoms between anal and oral sex
  • using latex gloves for fingering or fisting
  • using a barrier for rimming (such as a square of latex)
  • not sharing sex toys or douching equipment

Showering before and after sex is even better than washing!

Download the Shigella leaflet here.