Seattle outbreak of Shigella in 2 at-risk groups sparks concern

Health experts from the University of Washington in Seattle recently released research about growing cases of drug-resistant Shigella among two populations: gay men and homeless individuals.

Though the two populations fall into the classification of risk factors for those who are most prone to contracting the infection, health officials say it's important to pay attention to the spread because of the bacteria's increased resistance to antibiotics.

Most commonly, Shigella infections occur in children, but individuals who live in group homes or areas that lack sanitation and individuals who engage in male-to-male intercourse are also more prone to contracting it. 

In 2020 at Harborview Medical Center in Seattle, several cases among gay men were diagnosed, and physicians noted the cases were resisting antibiotic treatment. Then, not long after, cases in the homeless population rapidly emerged as well.

Ferric Fang, MD, a senior author of the study and director of the clinical microbiology lab at Harborview Medical Center, told University of Minnesota's Center for Infectious Disease Research and Policy in Minneapolis what was most concerning about the bacteria's drug resistance is its possibility for continued spread.

To treat the drug-resistant infections, physicians began rapidly testing symptomatic patients to determine what strain of the bacteria they had contracted and how to proceed with differing courses of antibiotics and infection control procedures. 

"This is very much an emerging threat and something where our public health tools and therapeutic tools have significant limitations," Dr. Fang said to CIDRAP.

Ultimately, physicians were able to determine the most prominent antibiotic resistant strain of Shigella causing infections in the Seattle region were likely "introduced to Washington State via international travel, with subsequent domestic transmission between at-risk groups," researchers wrote. 

Similar drug-resistant strains are on the rise and have also been recently reported in the U.K.

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