ACON is warning of a serious outbreak of drug resistant shigella, which causes bowel infections marked by vomiting, stomach cramps, diarrhoea, fever and nausea.

Shigella can cause infection when small, contaminated particles of fecal matter enter the mouth – meaning those who engage in practices like rimming are more susceptible.

Shigella will generally disappear through rehydration and rest, but if symptoms become severe antibiotic treatment is necessary to deal with the infection, known as shigellosis.

A strain of the bacteria has been found in New South Wales which is resistant to the recommended oral antibiotics used to treat the infection.

Intravenous antibiotics given in hospital have been recommended to treat the drug-resistant infections.

ACON CEO Nicolas Parkhill said the oral passage of the the bacteria can occur beyond just engaging in rimming.

“[The bacteria’s spread] can happen through sexual contact such as rimming, by getting infected faeces on your fingers and then touching your mouth or by putting contaminated objects like food, pens and cigarettes into your mouth.

“If you experience symptoms, it’s important that you see your doctor so you can get tested and be treated,” he said.

Craig Cooper, CEO at Positive Life NSW, warned that shigella can affect people living with HIV (PLHIV) more seriously.

“The symptoms of shigella can be worse for people with compromised immune systems, such as those with HIV, and this may result in hospitalisation,” he said.

Among 91 cases of shigellosis reported between November 2017 and April 2018, 31 per cent of instances involved a multi-drug resistant strain of the bacteria.

“However, it is likely the notifications aren’t reflective of the actual number of people with the infection, as many people sick with shigella will recover without seeing a doctor or getting tested,” NSW Health Medical Epidemiologist Dr Christine Selvey.

“We want gay men to be aware of ways that can reduce the risk of getting and spreading shigella.

“The most effective way is to wash hands thoroughly with soap and water after any sexual activity, touching equipment like used condoms and sex toys, going to the toilet, and before handling food,” she said.

Because shigella is highly contagious, it is advised that anyone affected avoid sex while experiencing symptoms and for a week after they have cleared.

A similar outbreak occurred in 2016, though in that instance the shigella was not identified as being antibiotic resistant.

For more information, visit the Ending HIV website.

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