LOS ANGELES — An outbreak cluster of 15 cases of Shigella flexneri infection, transmitted when feces comes into contact with the mouth, has occurred and is being investigated by the Los Angeles County Department of Public Health and the California Department of Public Health, Outbreak News Today reports.
Ten cases occurred among residents of Los Angeles County (including Long Beach and Pasadena, which are separate health jurisdictions). All of these cases of Shigella infection have occurred among men, disproportionately among gay/bisexual men, or men who have sex with men (MSM). Because accidental ingestion of even a tiny amount of fecal matter that contains Shigella can cause infection, men having sex with other men is a known risk factor for Shigella. To protect public health and prevent the future spread of Shigella, Public Health urges people to use a protective covering or avoid oral-anal contact during sex, Outbreak reports.
Despite this cluster of cases, the total number of Shigella flexneri cases reported through August to Public Health in 2016 is similar to that for 2015. In addition, the proportion of cases among men in 2016 (88 percent) is comparable to what was seen in 2015. This cluster was detected because it is caused by an uncommon serotype that has not been seen in California since 2014. The male predominance of Shigella cases each year, as well as the identification of cases among MSM, emphasize the risk in this group, whether or not a cluster is recognized, Outbreak News Today reports.
Shigellosis can be a severe illness, particularly in those with reduced immunity. Among the cases that have developed Shigella infection in Los Angeles County, there has been one death. Individuals who are infected with Shigella may develop diarrhea, fever, and stomach cramps. Illness generally lasts for about a week, although persons who are immunocompromised may be ill longer. Some people who are infected may have no symptoms at all, but may still pass the Shigella bacteria to others, the article notes.
“Gay and bisexual men are at increased risk and changing sexual practices by reducing oral-anal contact, such as by using a protective covering like a dental dam or saran wrap, may decrease risk,” said Robert Kim-Farley, MD, MPH, director of Communicable Disease Control and Prevention, said according to Outbreak News Today. “Maintain good hygiene. Wash your hands with soap and water and especially before, after and between sex.”