Shigella is an STI on the rise among gay and bi men in the UK – but have you ever heard of it?

You may have heard of more common sexually transmitted infections (STIs) such as gonorrhea, chlamydia, and syphilis. You might even know what the symptoms are and how to get treatment. But have you heard of Shigella?

Most of us who need to know about it haven’t heard of it, know very little about it, or don’t know how it is caused, diagnosed, treated, or prevented.

Shigella is a bacterium that causes an intestinal infection with symptoms ranging from nausea, severe diarrhea, vomiting, abdominal pain and fever. As the symptoms are similar, it is often mistaken for food poisoning.

It is usually caught after having sex with someone who is contagious by unwittingly ingesting feces (poo), especially through rimming. You can catch it by having penetrative sex, fingering, fisting, or sharing sex toys, as there may be small amounts of bacteria on your hands or things that end up in your mouth. Shigella can be transmitted through handling condoms if bacteria travels from your hands to your mouth. It can also be caught from contaminated water and food when traveling abroad.

Symptoms begin one to four days after exposure and last three to seven days, but may take longer. In some cases, the symptoms lead to hospitalizations.

It only takes a small amount of bacteria to make you sick
A common misconception is that a lot of bacteria are ingested to get sick, but it only takes a very small amount of bacteria for Shigella to be transmitted. Sex doesn’t have to be “messy” for it to be transmitted. Some people also carry it without any symptoms.

The disease can be quite serious
The symptoms can be physically immobilizing and people who have recovered may not feel better for a few weeks.

Many people who had it were shocked at how sick they got, describing it as the sickest they had ever been. Some people have diarrhea that contains blood or mucus, which can be troubling.

Symptoms MAY go away on their own
Not everyone needs treatment, as symptoms can disappear within a week. However, if you become seriously ill, you should see a clinician to get the right treatment to clear up the infection.

If you have a bad case of diarrhea after hookup, contact your sexual health clinic or GP and explain that you’ve had sex and your symptoms are consistent with Shigella.

There is a risk of dehydration
If you have frequent diarrhea, drink plenty of fluids to replace what you lose and avoid becoming dehydrated. Try to drink plenty of water, fruit juices and sports drinks that replace salts and minerals.

Taking pain relievers, such as paracetamol, can help relieve pain and fever, but it is advisable to avoid anti-diarrheal medications, such as Imodium, as they can make things worse.

Shigella can be VERY resistant to antibiotics
Symptoms may go away quickly, but if you have a particularly persistent case that lasts more than a few days, your sexual health clinic or GP should prescribe a short course of antibiotics. However, Shigella becomes more resistant to certain antibiotics, so you may need to give a stool sample to get the correct tests and antibiotics.

You could have been exposed to other STIs
If you have had sex that puts you at risk for Shigella, you may have been exposed to other STIs. Regardless of your HIV status, after a diagnosis of Shigella, it is advisable to have a full sexual health checkup at a clinic or by ordering tests online. Learn about U=U, PrEP, and vaccines for other STIs, such as hepatitis A, hepatitis B, and HPV.

It’s best to avoid sex until seven days after your last Shigella symptom ends to avoid spreading it to others.

You can avoid passing it on
It is possible to pass it on to people you live with or have close (non-sexual) contact with. Keep close contact with anyone else to a minimum, avoid sharing towels and washcloths, and wash your laundry on the highest setting possible.

Wash your hands with soap and warm water regularly throughout the day, especially after using the toilet, and do the same before handling, eating or cooking food, or handling babies and feeding the young or old to avoid transmission.

You can prevent Shigella by practicing hygiene
To do this, avoid resuming oral sex after anal sex or anal play begins, especially with new partners. Rimming, fingering and fisting also increase your risk, but you and your partners can reduce it by washing your hands, buttocks and genitals with soap and warm water after having anal sex or anal games.

For more information on Shigella, click here or call the free National Sexual Health Helpline on 0300 123 7123.

For the latest data on Shigella in England, click here.

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