'Extensively Drug Resistant' Illness Is Spreading Through the US: 'There Are No CDC Recommendations'
On Friday, the CDC issued an ominous advisory about the rise of an “extensively drug resistant” stomach bug in the United States.
The health advisory, which was issued mid-day Friday, warned about a spike in shigellosis across the United States.
While shigellosis and the Shigella infections have been known for some time now, it was only recently that drug-resistant (XDR) strains began popping up on the CDC’s radar.
“In 2022, about 5 percent of Shigella infections reported to CDC were caused by XDR strains, compared with 0 percent in 2015,” the CDC said in its advisory.
The CDC then warned that doctors have “limited antimicrobial treatment options” due to the resistant nature of the infections.
Compounding that matter, the CDC warned that Shigella bacteria is “easily transmissible.”
“Given these potentially serious public health concerns, CDC asks healthcare professionals to be vigilant about suspecting and reporting cases of XDR Shigella infection to their local or state health department and educating patients and communities at increased risk about prevention and transmission.”
“Shigella bacteria are transmitted by the fecal-oral route, directly through person-to-person contact including sexual contact, and indirectly through contaminated food, water, and other routes,” the CDC added.
Further along in the advisory, under the section labeled “Clinical Management,” the CDC doubled down on the relative hopelessness of the situation due to the strain’s drug-resistant nature.
“To date, there are no CDC recommendations for treating XDR shigellosis in the United States,” the CDC stated.
The CDC did follow that up with an interesting tidbit that there have been some positive studies to come out of the United Kingdom, but with some major caveats.
Chief among those caveats, one of the drugs that has shown promise in helping deal with XDR shigellosis (“oral pivmecillinam”) is not commercially available for use in the United States.
Interestingly, the CDC noted that while shigellosis has historically been an issue for young children (ages 1 to 4), there are now some very specific subsets of people who are also at an increased risk of XDR shigellosis.
Those groups include: Sexually active gay men, homeless people, international travelers and people with HIV.
The CDC elaborated on those groups with some interesting data.
Of the 239 cases of XDR Shigella strains reported between Jan. 1, 2015, and Jan. 22, 2023, the CDC reported that the “median age of patients was 42 years (range 1–83 years).”
The CDC then further broke down this drug-resistant stomach bug, noting that, “Among 232 patients with available information, 82 percent were men, 13 percent were women, and 5 percent were children. Among 41 patients who answered questions about recent sexual activity, 88 percent reported male-to-male sexual contact.”
Symptoms of shigellosis include: “Inflammatory diarrhea that can be bloody,” as well as “fever, abdominal cramping, and tenesmus.” (Tenesmus is the sensation of needing to pass stool, despite an empty bowel.)
So what is someone to do given the drug-resistant nature of these emerging shigellosis strains?
Fortunately, not much, as the CDC notes that most people should be able to make a full recovery with little treatment other than replacing fluids and staying hydrated.
“Most patients recover from shigellosis without antimicrobial treatment. Oral rehydration may be sufficient for many people with shigellosis.”
The CDC recommends the following to prevent the disease’s spread: Washing your hands, handling dirty diapers properly, and waiting at least two weeks after your diarrhea has ended before engaging in sexual activity again.
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