Sh-sh-sh Shigella - Dr. Dick

Sh-sh-sh Shigella

Dr. Dick,
The other night one of my roommates starting having out of control diarrhea. At first the guys and I thought it was hilarious...but when he started seeing blood, we took his ass to the ER. He didn't get better so they kept him overnight. Turns out he has something called Shigellosis! The doc gave him some antibiotics, and told him to be careful because he was still contagious. Now we're all paranoid that we're going to get it. We share everything: pipes, partners, you name it...
-Scared Shitless

My Dear Friend,
I'm sorry you're scared shitless. It sounds like your roommate has a nasty case of the runs! Shigellosis is a contagious diarrheal disease caused by Shigella bacteria. Anyone can get Shigellosis, but it's especially common among guys who have sex with guys. In fact, several shigellosis outbreaks in this population have happened around the world in recent years. Here's what you should know:

YOU AND THAT BOOTY
Shigella bacteria spreads easily through poop. Rimming and putting your mouth on dirty skin of the butt, groin, balls, and dick can spread the bacteria easily.

Shigellosis can also spread when an infected person doesn't clean their hands after using the bathroom, then prepares food or drinks for someone else. The bacteria can also spread for up to two weeks after a person is no longer sick with shigellosis symptoms.

SYMPTOMS
Symptoms include diarrhea (sometimes bloody); fever, and stomach cramps. Some people also get what's called Tenesmus, a painful urge to poop even when the colon (bowel) is cleaned out.

If you start having symptoms of shigellosis, it's very important to see a medical provider so they can find out for sure what's wrong. People with compromised immune systems (like through HIV infection) may have more severe symptoms that last longer than normal. Your medical provider might ask you to provide a sample of your poop so that it can be tested for specific bacteria.

CARING FOR YOURSELF
For most people infected with shigella, symptoms usually go away in five to seven (5-7) days. Drinking lots of fluids and resting are important ways to care for yourself. Avoid over the counter drugs to slow down the diarrhea (e.g. loperamide) as these can prolong symptoms. If you can, take a break from partying, which will run your immune system down further.

Sometimes the diarrhea is severe enough that you will need a prescription for antibiotics. Take the antibiotics exactly as directed! *Do not try to treat yourself with antibiotics that you buy online or on the street. Treatment requires a specific type of antibiotics, under the care of a medical provider. If you do receive antibiotics and do not feel better in a couple of days, tell your medical provider as there have been reports of antibiotic resistant shigella.

Most people who get shigellosis infection make a full recovery, but sometimes it can take months for a person's poop schedule to get back to normal. Reinfection with the same type of shigella bacteria usually won't happen to a person for several years. However, a person can get infected with one of the other types of shigella (there are four strains of the bacteria).

PREVENTING SHIGELLOSIS
There is no vaccine for shigellosis. Safer sex practices and careful handwashing are some of the best ways to prevent this bug.
• Try a dam for rimming: Dams are made of latex or polyurethane (for our friends who have latex allergies), and placed over the anus or vagina to shield one another from fluids, sores, and skin-to-skin contact. You can also get Hepatitis A and intestinal parasites from rimming. Like condoms, dams should be used once, and then thrown away.
• Oral sex condoms are non-lubricated and flavored. Add some water-based lube inside the condom to increase sensation for your partner. Put some flavored lube on the outside of the condom to make it a juicier experience for you.
• P n' P can spread shigellosis like wildfire. Stock up on supplies like dams and condoms before you jump into the ring. Use your own pipe and keep all other paraphernalia to yourself.
• Having sex while you have diarrhea isn't a good idea (and frankly doesn't sound like much fun). Avoid having sex if you have diarrhea, and try to wait for at least one week after symptoms are gone, to ensure that you aren't contagious anymore.
• If you do have sex while you have symptoms, use condoms for sex; dams for rimming; and gloves/fisting gloves for fisting and fingering.
• Wash your hands with soap and warm water after sexual activity. This is important after touching items like sex toys, condoms, etc; after using the toilet; and before preparing and handling food and drinks. Clean sex toys before use, according to manufacturer's instructions.
• Tell your sexual contacts about your infection, so they have some information if they start getting symptoms. Shigellosis can be rough on the body, and connecting with a medical provider is important!

Be well!
Dr. Dick

More info from Public Health--Seattle & King County :
Sex and shigellosis_04-15.pdf

Community alert_final.pdf

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