According to a report released by the U.S. Centers for Disease Control and Prevention, the drug-resistant bacteria Shigella sonnei is making its rounds across states, getting 243 people sick in the county and in Puerto Rico from May 2014 to February 2015, spread by international travelers.
Tom Friedman, CDC director, explained that drug-resistant infections are more difficult treat. Since Shigella so easily spreads between people, this makes the threat of an outbreak very real. The CDC and it public health partners have investigated recent clusters of Shigella infections in Pennsylvania, California and Massachusetts and found that almost 90 percent of cases are resistant to the antibiotic ciprofloxacin, the first choice for treating shigellosis in adults in the U.S.
Most Shigella strains in the country are resistant to trimethoprim/sulfamethoxazole and ampicillin while resistance to Cipro is a global trend.
"The increase in drug-resistant Shigella makes it even more critical to prevent shigellosis from spreading," said Anna Bowen, a medical officer with the CDC Waterborne Diseases Prevention Branch and the lead author of the report.
Shigella leads to about 500,000 diarrhea cases in the country each year, spreading rapidly and easily from one person to another through contact with food and water that has been contaminated. Symptoms include fever, abdominal pain, malaise and bloody or watery diarrhea. While Shigella-induced diarrhea usually subsides even without treatment, antibiotics may be administered to stop diarrhea sooner. Unfortunately, this has led to up to 90 percent of tested samples showing resistance to Cipro whereas the drug-resistance rate for the infection used to be just 2 percent.
With drug-resistant Shigella spreading, the CDC is advising doctors to run lab tests to help determine the antibiotics that will be of most effective in treating an infection. This will also help assess if a case of shigellosis even needs antibiotics in the first place.
To help curb the spread of Shigella, the CDC recommends hand-washing with soap and water, particularly before eating or preparing food and coming from the toilet. Children should also be kept from group activities when they are sick and swimming must be avoided for several weeks after recovering from an infection.
Travelers are also advised to reserve antibiotic use for extreme cases of diarrhea, instead using bismuth subsalicylate for prevention and loperamide for treatment. Opting for safe food and drinking only from sealed and clean containers as well as washing hands frequently will also help in keeping cases of travelers' diarrhea down.
About half of the Shigella cases the CDC tested have been associated with international travel, particularly to India and the Dominican Republic, based on patient information provided.
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