Rise in Drug-Resistant Shigella Cases Prompts Health Alert
A concerning increase in sexually transmitted Shigella infections, coupled with growing antibiotic resistance, is prompting a public health alert in England. New data from the UK Health Security Agency (UKHSA) reveal a significant rise in cases, particularly among gay, bisexual, and other men who have sex with men (GBMSM). This surge underscores the urgent need for heightened awareness, preventative measures, and improved surveillance of antimicrobial resistance.
Case Numbers and Trends
In 2025, 2,560 cases of sexually transmitted Shigella were diagnosed in England, marking a substantial increase from 2,052 in 2023 and 2,318 in 2024 . Shigella is a bacterial infection spread through fecal matter and can be transmitted through sexual contact, direct contact, or via unwashed hands. Symptoms, which often mimic food poisoning, typically appear within one to four days and include diarrhea (sometimes bloody), stomach cramps, and fever.
Antibiotic Resistance a Growing Concern
Alongside the rising case numbers, the UKHSA data highlight a serious and escalating problem of antibiotic resistance. In 2025, 86% of Shigella sonnei samples and 94% of Shigella flexneri samples tested exhibited resistance to antibiotics . Notably, more than half of Shigella sonnei cases were classified as extensively drug-resistant (XDR), meaning limited treatment options are available for severe infections. While many cases resolve without treatment, the increasing resistance poses a challenge for managing more severe presentations.
Impact on GBMSM
The UKHSA data indicate that sexually transmitted Shigella predominantly affects GBMSM. The reasons for this disproportionate impact are currently under investigation, but factors may include sexual practices and network effects within the community. Public health messaging and targeted interventions are crucial to address the specific needs of this population.
Public Health Recommendations
Dr. Katy Sinka, Head of the STI section at UKHSA, emphasized that the risk of contracting Shigella can be reduced through practicing good hygiene during and after sex, and through condom use . Individuals experiencing symptoms are advised not to dismiss them and to seek guidance on self-care and preventing dehydration, with resources available on the National Health Service (NHS) website. Given the potential for co-infection, individuals diagnosed with Shigella are also recommended to undergo a sexual health screen to test for other sexually transmitted infections, including HIV.
Preventative Measures and Infection Control
Following a diagnosis of Shigella, individuals should abstain from sexual activity for seven days after the resolution of their last symptom. Additional precautions include avoiding communal spaces like spas, swimming pools, and hot tubs, refraining from sharing towels, and carefully practicing food hygiene to prevent further transmission. The World Health Organization (WHO) recommends thorough handwashing with soap and water, especially after using the toilet and before preparing food, as a fundamental measure to prevent the spread of Shigella and other diarrheal diseases .
Broader Implications and Ongoing Surveillance
The rise in drug-resistant Shigella cases is part of a wider global trend of increasing antimicrobial resistance, which poses a significant threat to public health. Continued surveillance, research into new treatment options, and public health interventions are essential to combat this challenge. The UKHSA is monitoring the situation closely and will continue to provide updates and guidance as new information becomes available. Read more on Globally Pulse Health .
