Drug-resistant stomach bugs are on the rise, CDC warns. Here’s how to prevent infection

After a surge in RSV cases and flu dominated the scene this winter, the Centers for Disease Control and Prevention (CDC) is now sounding the alarm about an increase in stomach infections that don’t respond to antibiotics. Caused by an “extensively drug-resistant” strain of Shigella spp. bacteria, the rise in shigellosis cases across the U.S. is especially worrying for parents of young kids—as children under age 5 are the most likely to get infected. 

That said, people of all ages can get the disease, and the CDC estimates that Shigella causes around 500,000 cases of diarrhea in the U.S. each year. The illness usually goes away on its own, but moderate or serious infections can be hard to treat, as treatment options are already limited—and may be even more so now with the discovery of an increase in antibiotic-resistant strains. It’s also highly contagious. 

But most cases in kids are mild, so try not to worry. “Many people who contract shigellosis can be on the mend within 5 to 7 days without antibiotics,” says Ali Alhassani, MD, Head of Clinical at Summer Health, a pediatric telehealth platform, and a pediatrician at Boston Children’s Hospital. “If this new strain does not cause an increase in the severity of illness, the normal treatment protocol should suffice which may not require antibiotics.”

Here’s what you need to know about spotting the signs of shigellosis in kids and how to prevent the infection from spreading. 

What is Shigella spp.?

The family of bacteria that causes the infection shigellosis, Shigella spp. is found in the stool of an infected person. “As children who are sick touch toys and other shared objects, this bacteria can infect children as they touch contaminated surfaces and then their mouth,” explains Dr. Alhassani, which is why Shigella outbreaks are often localized to daycare centers and schools. 

Should you be worried about the rise in drug-resistant shigella?

“According to the CDC in an advisory report released last week, 5% of Shigella infections reported to them in 2022 were the drug-resistant strains (labeled XDR). That’s up from 0% in 2015,” Dr. Alhassani says. “However, the CDC report did mention that while the typical strains of Shigella affect younger children more, these XDR strains are observed more in specific adult populations such as men who have sex with men, people experiencing homelessness, international travelers and those with HIV.” 

Most shigellosis cases are considered self-limiting, notes the CDC, which means that they resolve on their own without antibiotic support, and people usually recover within 5 to 7 days. But it is always worrying when a common bacterial infection becomes resistant to the treatments we have available. 

According to William Schaffner, MD, an infectious-disease specialist and professor of preventive medicine and health policy at the Vanderbilt University School of Medicine in Nashville, the growth in resistance could be related to the overuse of antibiotics. “The more antibiotics we use, the more resistance we will generate,” he said to Everyday Health. “We just need to be much more careful and restrained in how we use antibiotics.”

Symptoms of shigellosis in kids

Shigellosis in kids is typically marked by watery diarrhea. Here are other symptoms you might expect:

• Diarrhea that contains blood or mucus
• Belly cramps
• Fever
• Loss of appetite
• Nausea and vomiting
• Painful bowel movements
• Tenesmus, or the feeling of needing to poop even though your bowels are empty

Because shigellosis can cause diarrhea that lasts for several days, be on the lookout for dehydration or seizures in severe cases, notes Dr. Alhassani.

How is shigellosis in kids usually treated?

Mild cases of shigellosis can be supported with plenty of fluids, small amounts of bland foods and lots of rest. A children’s electrolyte formula may be helpful to prevent dehydration, and you might look to fever reducers to help your child feel more comfortable, but otherwise, time is your best resource here. While antibiotics are available that can shorten the duration of the illness (usually by about 2 days), Dr. Alhassani says they’re not always necessary if the infection is on the milder side. 

How to protect your family from Shigella

Shigella is very contagious—the bacteria can shed from an infected person’s stool for up to 4 weeks after other symptoms disappear. “As with many other viruses/bacterial infections, practicing good hand hygiene is important to stay healthy.  If someone in the household is infected, it’s important to reduce the frequency of using shared household items to reduce the risk of spreading the illness,” Dr. Alhassani shares. 

Here are other ways to keep your family from getting sick:

• Wash hands thoroughly after using the bathroom
• Wash hands thoroughly before eating or preparing food
• If you’re caring for a child with diarrhea, try to avoid preparing food for others, and wash your hands before touching other people. 
• Disinfect toilets and bathroom fixtures often when there’s an active infection
• Place diapers worn by a child with shigellosis in a sealed garbage can, and wipe down the changing table with disinfectant spray after every use. 

Your child’s pediatrician may also have more tips to share. And remember that to prevent the spread of germs within your community, aim to keep kids with diarrhea or fever home from school until symptoms resolve.

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