Several different strains of Shigella are circulating in NSW with resistance to key recommended antibiotics. Of the 60 notifications of shigellosis in April and May 2019, 59% 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 that most of these infections represent a single outbreak, which is thought to have been introduced by a returning traveller. This strain, Shigella sonnei biotype G, is resistant to all recommended oral antibiotics for shigellosis, including ciprofloxacin, cotrimoxazole, ampicillin/amoxicillin and azithromycin. For severe infections with this strain, intravenous (IV) antibiotics (through the vein) is the recommended treatment, which is provided in hospital.
However, other multi-drug-resistant Shigella strains have been identified with different drug-resistance profiles.
If you have symptoms of shigellosis
See your doctor.
While you are waiting for confirmation of your infection and effectiveness of antibiotics, follow the advice below to prevent the spread of Shigella, as shigellosis readily spreads from person to person.
Antibiotics reduce infectiousness and may also shorten the duration and severity of illness, however we recommend your doctor wait until antibiotic susceptibility results are available before prescribing antibiotics in case your strain of infection is found to be resistant to the usual antibiotics prescribed.
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 for others, share utensils, provide personal care for others, or 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
For further information please contact your local public health unit on 1300 066 055.