A new strain of Shigella is disproportionately impacting queer men. Why?

What is Shigella?

According to Thomas, Shigella is a genus of bacteria that is highly contagious and includes several species, like flexneri, sonnei, and dysenteriae, all of which can cause an infection called Shigellosis and result in diarrhea.

How does Shigella spread?

The infection spreads through microscopic particles of fecal matter, which is why it was once most common in school settings with young children or in regions where clean water is hard to come by. It also means that if you are having sex that involves your mouth and anus, these particles can spread from an infected person to their sexual partner, or their sexual partner’s partner.

“It’s very contagious, and it doesn’t take much exposure to get sick,” Daskalakis says.

According to Thomas, it’s a common misconception that you can only contract Shigella from rimming or being rimmed. He said that he has actually had several gay men come into his office with no history of rimming who have contracted numerous enteric infections, or illnesses caused by microorganisms like bacteria, viruses, and parasites.

“With the rise of group sex in bath houses, dark rooms, and sex parties, I feel that there is a lack of understanding that you can get it from giving head to someone who just plowed someone else without protection and without cleaning off effectively or from being penetrated by someone rectally in the same scenario,” Thomas says. “This happens way more than people think.”

Even after someone receives treatment for Shigella, they can remain contagious for a few weeks, even if they no longer have symptoms.

“I feel that this is probably where most infections are spreading because many people get treated and then have no symptoms and go right back to sex,” he says.

How is Shigella treated?

Because cases of shigellosis can range from mild to life-threatening, treatment protocol greatly depends on what your doctor decides is the best course of treatment for your specific case. Usually, rehydration through oral or IV fluids is necessary, and in severe cases, a course of antibiotics may also be prescribed. Doctors stress that it’s important to start by confirming your diagnosis through testing if you suspect you’ve contracted it.

“Most cases don’t require treatment with antibiotics unless it’s a severe case or the person with the infection has a weakened immune system,” Daskalakis says.

How do you prevent Shigella from spreading?

Prevention begins with an understanding of the basics of how bacteria spread.

“Prevention is really about layering protections,” Daskalakis says. “Handwashing with soap and water, especially after using the bathroom or before eating, matters a lot. Avoiding sex when someone has diarrhea, and washing hands, bodies, and sex toys before and after sex can significantly reduce risk.”

If you’re engaging in group sex or sex in dark rooms, Thomas recommends taking a few extra precautions.

“Don’t bottom (especially in an unprotected group situation) or let someone eat your ass if you recently or are currently having bowel issues or were very recently treated,” he says. “You may be [infectious] for a few weeks after! (At least 2 weeks). At sex parties, if you are a top and penetrate someone (especially bareback), make sure you wash off thoroughly before you put it in the next person’s mouth or ass.”