Since 2023, an increasing number of cases of shigellosis infections have been detected in Berlin and Europe. There is a similar trend in London. The strain circulating there is resistant to several antibioticsand has already been detected in Berlin.

Shigellosis

Like hepatitis A, shigellosis is transmitted fecally orally. Primarily through water contaminated with human faeces. The bacteria are mainly transmitted sexually during anal-oral contact: So from the anus into the mouth or as smear infections, for example from the anus via the finger into the mouth during sexual intercourse:

• Rimming/Ass licking
• Anal sex, especially if followed by a blowjob
• Contact with used condoms or dildos
• jointly used sliding gel pots (there is also a risk of HEP A, HEP B and HEP C)
• from rectum to rectum via shared sex toys
• specific sex practices, such as scat (sex practices where the fetish is faeces)

Even the intake of a few germs can lead to the disease. The incubation period is 1-4 days.

If you are suffering from diarrhea, you should limit your sexual contact for at least seven days. You should refrain from anal-oral practices for 4-6 weeks.
If you have cramping, prolonged diarrhea with bloody mucus, you should definitely visit a doctor’s office and point out the possibility of a Shigella infection.

The disease

Shigella begins typically one to several days after infection with diarrhea, abdominal cramps and fever, nausea, vomiting and headaches. However, the severity and duration of the disease can vary greatly from person to person. Besides severe cases with bloody-purulent-mucous diarrhea occurring 10 to 40 times a day, which are associated with severe cramps, there are also cases in which there is only watery diarrhea or asymptomatic courses (but in which bacteria are still excreted). Without treatment, the ulcers caused by the bacteria can break through the intestinal wall
and lead to life-threatening peritonitis.

Info+ Shigellosis can be particularly severe and sometimes life-threatening in people with HIV, but also in young children and the elderly.

The bacteria usually disappear spontaneously from the stool after about 1-4 weeks, but the infection can also become chronic. The affected people then excrete Shigella in their stool over a long period of time – often without symptoms occurring – and thus represent a permanent source of infection for others.

This allows the disease to spread further and faster, if you do nothing about it. Especially due to the new resistant strains.

Protection

• Condoms only provide limited protection against smear infections.
• Dildos and sex toys that are introduced anally should be washed thoroughly after use or before each use with a new partner and disinfected if possible or provided with a new condom.
• Generally do not use lubricating gel pots, but a new tube or similar for each butt.

When to see a doctor

If you notice the unspecific signs of illness, such as diarrhoea, abdominal cramps and fever, nausea, vomiting and headaches, see your doctor immediately. The doctor can treat the disease with an antibiotic. ATTENTION Resistant strains are in circulation, so the standard treatment may not work!

Therapy

The treatment is carried out with antibiotics until no more pathogens can be detected in three consecutive stool samples taken at intervals of two days (this usually only takes a few days).

Other measures

During therapy, care should be taken to wash your hands thoroughly, especially after each visit to the toilet and before preparing or eating meals. Sex involving contact with the anus should be avoided until the disappearance of the shigella is proven. Sick people may not work in communal facilities, catering establishments and food processing plants as long as they excrete Shigella.

Further information on this and other STIs here.