Nationally, we’re currently seeing a rise in cases of drug-resistant Shigella - especially in the community of men having sex with men. While most cases have been seen on the West Coast of the USA, we’ve also diagnosed a case of Shigella at one of our own offices. We want you all to know that Central Outreach is aware of the current situation, we have already encountered cases of it, and we can help you treat it!
So here is what you should know before tonguing that booty hole…
What is Shigella?
Shigella (pronounced shug-gel-luh) also known as Shigellosis, is a diarrheal illness caused by gram-negative bacteria. Shigella infection is spread through fecal-oral transmission and sexual contact, such as rimming. Historically, this has been an illness usually spread through children in a daycare setting or people who have traveled to countries with poor sanitation, but recently the majority of the diagnoses have been in adult men, primarily men who have sex with men. Although most infections are self-limited and cure themselves within 5 to 7 days, antibiotics should be prescribed for severe illness or to reduce transmission in settings with high risk for spread.
Shigella Symptoms
Symptoms typically appear 1 to 2 days after exposure and normally last 5 to 7 days.
- Diarrhea: Often watery and may contain blood, mucus, or pus.
- Abdominal Pain: Severe stomach cramping or tenderness in the gut.
- Fever: Can be high and accompanied by discomfort.
- Tenesmus: A frequent, painful urge to pass stool even when the bowels are empty.
Prevention Strategies for High-Risk Groups
Because Shigella can appear in the stool for several weeks after symptoms vanish, the CDC recommends the following:
- Hand Hygiene: Wash hands with soap for at least 20 seconds after using the bathroom, changing diapers, or before handling food.
- Safe Sexual Practices:
- Abstain from sex (oral, anal, or vaginal) while you have diarrhea and for at least two weeks after it resolves.
- Wash hands, genitals, and the anus with soap and water before and after sexual activity.
- Use barriers like condoms, dental dams, and gloves during oral-genital or oral-anal sex.
- Clean your sex toys!
- Know your partners & risks - If you’re engaging in higher-risk activities, being aware and informed can help you make the best choices for your health.
- Food and Water Safety: Avoid swallowing water while swimming in pools, lakes, or oceans. When traveling, stick to bottled or boiled water and thoroughly cooked foods.
What we recommend if you have symptoms!
Get tested! If you have diarrhea that won’t go away or other gut issues after sex, ask your doctor for a stool test. Regular STI tests won’t catch these infections.
Have you experienced diarrhea for more than 5 days? Need testing or more info? We’ve got you covered - reach out to us anytime at 855-5-WE-CARE or visit www.centraloutreach.com!
One last thing!
Rimming can be a great experience between you and your partner(s). Understanding the risks of Shigella means you can take steps to protect yourself while still enjoying the pleasure and connection you deserve. So go forth, get tested when needed, and keep that gut (and that 🍑) happy!
“Remember to protect yourself when there is contact involving the mouth and another person’s body, the key idea is reducing the chance of transmitting infections.
- Barrier protection such as a dental dam or a thin piece of latex designed for oral contact on skin or mucous membranes
- Good hygiene for both partners before and after intimate contact
- Regular sexual health checkups, since many infections don’t show symptoms
- Avoiding contact if either person has cuts, sores, or active infections in the area”
From one of our trusted providers, Paul Debes
Sources
Booty, Bottoms, & Bacteria: What You Need to Know About Sexually Transmitted Gut Infections
https://www.centraloutreach.com/blog/booty-bottoms-bacteria-what-you-need-to-know-about-sexually-transmitted-gut-infections
Fosfomycin: the characteristics, activity, and use in critical care
https://pmc.ncbi.nlm.nih.gov/articles/PMC6441553/
Extensively drug-resistant Shigella on the rise in US, CDC warns
https://www.cidrap.umn.edu/shigella/extensively-drug-resistant-shigella-rise-us-cdc-warns
Emergence of Extensively Drug-Resistant Shigellosis — United States, 2011–2023
https://www.cdc.gov/mmwr/volumes/75/wr/mm7513a1.htm
Preventing Shigella Infection
https://www.cdc.gov/shigella/prevention/index.html
Increase in Extensively Drug-Resistant Shigellosis in the United States
https://www.cdc.gov/han/2023/han00486.html
P-563. Extensively Drug-Resistant Shigella Cases — San Francisco, California, 2021 to 2024
https://pmc.ncbi.nlm.nih.gov/articles/PMC12793076/
Increase in Shigella Cases - 2025
https://srhd.org/shigella-advisory-for-health-care-providers-jan-23-2025#:~:text=Spokane%20County%20is%20beginning%20to,is%20sufficient%20to%20cause%20infection.
