NSW Health has detected an increase in the number of shigellosis cases with resistance to key recommended antibiotics. Of the 91 notifications of shigellosis in the six month period November 2017 to April 2018, 31% were found to be resistant to multiple classes of antibiotics.
The majority of these infections are thought to have been acquired through male to male sexual contact. Genetic sequencing of the isolates indicates these infections represent a single outbreak, which is thought to have been introduced by a returning traveller.
This strain of Shigella sonnei biotype G is resistant to six classes of antibiotics, including ciprofloxacin, cotrimoxazole, ampicillin/amoxicillin and azithromycin. This means that there is no recommended oral antibiotic available for these infections. In these cases, intravenous (IV) antibiotics (through the vein) is the recommended treatment, which is provided in hospital.
If you have symptoms of shigellosis
See your doctor.
Antibiotic therapy is recommended in NSW as shigellosis readily spreads from person to person. Antibiotics reduce infectiousness and may also shorten the duration and severity of illness. Your doctor may prescribe antibiotics while waiting for results, but they may need to ask you to return a few days later if your strain of infection is found to be resistant to the antibiotic you have been prescribed.
While you are waiting for confirmation of your infection and effectiveness of antibiotics, follow the advice below to prevent the spread of Shigella.
If you have been diagnosed with shigellosis
To prevent the spread of antibiotic resistant shigellosis:
- Don’t have sex (especially where there is any contact with the anus) until no longer infectious (usually 1 week after symptoms resolve).
- Don’t prepare food or drink or share utensils, provide personal care for others, share linen or towels while sick.
- Don’t swim in a pool until 24 hours after the diarrhoea has stopped.
- Wash your hands often and thoroughly, especially after using the bathroom and before eating.
- Patients who work in 'high-risk' jobs for spreading Shigella should not return to work until 48 hours after their diarrhoea has stopped. This includes people who work as food handlers (such as kitchen staff and waiters, butchers) and those who care for patients, children or the elderly.
Information for health professionals
ACON media release [18 August 2018]
For further information please see the shigellosis factsheet or contact your local public health unit on 1300 066 055.