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Home News centre National Press Releases 2012 Press Releases ›  Risk in UK Shigella Infections Prompts advice for men who have sex with men

Risk in UK Shigella Infections Prompts advice for men who have sex with men

30 March 2012

An increase in cases of dysentery caused by shigella infection has been identified among men who have sex with men (MSM) across the UK, according to preliminary findings from a Health Protection Agency (HPA) investigation published today (Friday) in Eurosurveillance.


An increase in cases of dysentery caused by shigella infection has been identified among men who have sex with men (MSM) across the UK, according to preliminary findings from a Health Protection Agency (HPA) investigation published today (Friday) in Eurosurveillance.

Following two outbreaks of shigella infection among MSM in Greater Manchester and London last year, affecting around 20 men, the HPA put in place ‘enhanced surveillance’ in September 2011 to try and ascertain the extent of the problem across the UK.

Shigella dysentery is often acquired by drinking contaminated water or by eating food washed with contaminated water. In the UK most cases of shigella are associated with foreign travel.

The enhanced surveillance, which ran from September to December 2011, picked up 145 cases of shigella infection, of which 31 were UK acquired. Of these 31 cases, they were predominantly male and just under half reported MSM activity within the previous week. The investigation showed that these men attended regular health checkups and all reported having a casual male partner in the preceding week.

These findings suggest that the UK acquired cases in men who have sex with men may be transmitted through sex or through secondary contact. Although the enhanced surveillance gives an indication of the numbers affected, it does not pick up all of the cases and the HPA believes the current UK outbreak of shigella is considerably larger than this.

As a result of these preliminary findings, the HPA is stressing the need for men who have sex with men to consult their doctor if they have diarrhoea, especially if it is bloody, and for health professionals to be on the alert for possible cases in men who have sex with men.

Dr Isabel Oliver, head of the outbreak control team said “It’s very unusual to see outbreaks of this illness that are not linked to foreign travel which is why we undertook extra surveillance to try to understand who the disease is affecting and why.

“Our investigation has revealed a strong association between UK acquired shigella and onward transmission in men who have sex with men.

“We also know that the cases are not part of one large outbreak, but are small clusters happening across the country, therefore it is important to be aware of simple precautions to stop the spread of the infection.

“We continue to advise people in these groups to go to their doctor if they have diarrhoea, to see whether they’re infected with shigella. If they do have this illness, avoiding having sex until they’ve made a full recovery will reduce the risk of onward transmission.

“Washing hands thoroughly before preparing and eating food, after going to the toilet and, if having sex, before and afterwards, may also lower the risk of people with this illness spreading it to others. Ingesting even a small number of shigella germs can lead to infection.

“As part of the investigation we also worked with the Terence Higgins Trust and the British Association for Sexual Health and HIV to raise awareness of shigella and its symptoms to men who have sex with men and health professionals.

“Investigations into other risk factors for onward transmission and the possibility of using screening tests to diagnose infection in asymptomatic contacts of cases with shigella dysentery continue.”

The main symptom of shigella is bloody diarrhoea – which should always be investigated by a doctor. People who are diagnosed with this illness can be treated with antibiotics, and most people in this country will make a full recovery and experience no complications.


-ENDS-

Notes to editors

1. Borg et al. Investigation of a national outbreak of shigella flexneri serotype 3a in men who have sex with men, England and Wales, 2009 – 2011 (2012). Eurosurveillance http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20137  

2. Link to previous news release about Manchester and London outbreaks:
http://www.hpa.org.uk/NewsCentre/NationalPressReleases/2011PressReleases/111007ShigellaFlexneri/

3. Link to shigella leaflet put together with Terence Higgins Trust:
http://www.tht.org.uk/informationresources/otherstis/shigella/content.htm

3. More information on Shigella dysentery can be found on the HPA website: http://www.hpa.org.uk/Topics/InfectiousDiseases/InfectionsAZ/Shigella/

4. The Health Protection Agency is an independent UK organisation that was set up by the government in 2003 to protect the public from threats to their health from infectious diseases and environmental hazards. In April 2013, subject to the usual approvals procedures for establishing new bodies, the Health Protection Agency will become part of a new organisation called Public Health England, an executive agency of the Department of Health. To find out more, visit our website: www.hpa.org.uk or follow us on Twitter @HPAuk.

5. For more information please contact the national HPA press office at Colindale on 0208 327 7901 or email colindale-pressoffice@hpa.org.uk. Out of hours the duty press officer can be contacted on 0208 200 4400.
 

Last reviewed: 1 May 2012