Sexually transmitted diarrhea disease - what it is and is it fatal?

Shigella, a bacterium responsible for dysentery, continues to be a public health challenge in the United States as infections spread through several routes and become increasingly concerning to treat. Although the illness is commonly linked with contaminated food, water and poor hand hygiene, sexual transmission is also resulting in its spread. Researchers are trying to understand why infections are increasing in some communities and why drug-resistant strains are complicating treatment.

What is shigella and how is it spread?

Shigella can cause diarrhea containing blood or mucus, abdominal pain, stomach cramps, fever and vomiting.

The disease can also become dangerous when it results in severe dehydration and the loss of bodily fluids like blood. Critical complications can include bacterial and septic shock, neurological issues, internal bleeding and infection.


Transmission typically happens when infected fecal matter enters the mouth. This can happen through inadequately washed hands or the consumption of contaminated food or water.

Sexual transmission is contributing to the spread

A study published in July discovered that the year-over-year increase in sexual transmission between 2015 and 2020 was 15% more than the growth associated with travel, contaminated food or nursery outbreaks.

Emerging proofs also indicate that sexual contact may now be a major route of transmission. However, determining its complete contribution is challenging as sexual exposure is not always discussed or recorded when patients seek medical care.

“Together, it's a very concerning pattern of XDR Shigella strains that are being seen among vulnerable populations," epidemiologist Naeemah Logan from the CDCstated to CIDRAP News.

Logan also emphasized the international nature of the concern, citing, "This is by no means unique to the US, but really part of a broader global pattern."

Research from the United Kingdom has also found a similar rise in sexually transmitted Shigella infections. Kate Baker, a geneticist at the University of Cambridge and senior author of a recent study published inThe Lancet Infectious Diseases, has analyzed the growing spread of the infection in sexual networks.

The findings suggest two linked problems: sexual transmission of Shigella, and the emergence of strains resistant to multiple antibiotics. Experts have highlighted the importance of recognising these transmission patterns and improving awareness of the infection.

Complicated by drug resistance Treatment

The number of infections is rising – and there’s another problem. Shigella is becoming increasingly resistant to antibiotics.

As per the US Centers for Disease Control and Prevention (CDC), the proportion of shigella strains resistant to drugs elevated from 0% in 2011 to 8.5% in 2023.

The CDC has reported that drug-resistant shigella cases involved adult men more. Research published in The Lancet Infectious Diseases has also discovered that people who acquired shigella through sexual contact spent an average of four to five days in hospital.

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Why awareness matters

Shigella features a growing challenge as it can spread through daily contact with contaminated material as well as through sexual activity. The increasing prevalence of drug-resistant strains further complicates the problem of treating critical infections.

Much of prevention is knowing the many ways the bacterium is spread, following hygiene precautions, and seeking appropriate medical advice if symptoms occur.Researchers continue to study the shifting patterns of infection, but public awareness and effective prevention measures are key to limiting its spread.