Shigella: What to Know About America's New Drug-Resistant Bug

News that a stomach bug is becoming resistant to antibiotics is alarming, but before you start fearing the so-called new bug, there are a few things you should know.

The Centers for Disease Control and Prevention reported this week that the bacteria Shigella sonnei has become resistant to ciprofloxacin, the antibiotic that used to shorten the illness it caused and lessen its severity. The agency identified 243 cases of shigellosis in 32 states and Puerto Rico. Testing 126 of them, officials determined that 109 cases were resistant to antibiotics.

Here's what to keep in mind:

The bug is not new.Shigella causes an estimated 500,000 cases of diarrhea each year, according to the CDC. It's commonly associated with traveling outside the United States, but 95 cases were recently reported as part of an outbreak among the San Francisco homeless population.

The rest of the world has been dealing with this antibiotic resistant strain for years, said Dr. Amy Edwards, an infectious disease specialist at U.H. Case Medical Center in Cleveland, Ohio, adding that it's not surprising that it's finally reached the United States.

Others agree."This is the next story on yet another bug that has developed resistance to multiple antibiotics," said Dr. William Schaffner, chair of preventive medicine at Vanderbilt University in Nashville, Tennessee. "In addition, it's a global problem because people are traveling abroad acquiring this bug with multiple resistant aspects and bringing it back to us and spreading it in the United States. So there are several new twists about this."

It spreads easily."Shigella is a bug that's spread from person to person very, very readily," Schaffner said. "It doesn't take much of the bug to initiate an infection, and it produces quite an unpleasant diarrheal illness."

When it gets into a daycare in the United States, he said, it usually spreads among children before hitting mothers a little more frequently than fathers because they're often in closer contact with the sick children.

The reason it's so contagious is that it's resistant to your stomach acid, Case Medical Center 's Edwards said. As a result, it doesn't take much to make someone sick.

But it's not usually deadly.Shigella isn't as deadly as CRE or MRSA, two other antibiotic-resistant bugs that have been sweeping the nation's hospitals in recent years. (CRE made headlines earlier this year when an outbreak tied to contaminated endoscopes sickened several people at Ronald Reagan UCLA Medical Center, killing two of them.)

"Most cases get better in two, three, maybe four days on their own," Edwards said. "The vast majority of people recover OK."

Shigella results in a gastrointestinal illness that's as bad as or worse than salmonella or e. Coli, according to Schaffner. Symptoms include fever, abdominal pain, diarrhea, or bloody diarrhea, that can last several days or more than a week, resulting in dehydration, he said. In some cases, patients may need to be hospitalized for intravenous fluids.

In rare cases, a patient can die after they become dehydrated, which affects their bio-mechanics, Schaffner said. He added that young children, the elderly and people with underlying health conditions are most at risk for developing severe illness and life-threatening complications.

There's a big picture threat, however.The White House last week unveiled its five-year plan to combat antibiotic resistance. A 2013 CDC report revealed that antibiotic-resistant bacteria sickens at least 2 million Americans each year, killing 23,000 of them.

"This is one of those problems that doesn't always rise to the top of people's day-to-day concerns until somebody in the family is impacted," President Obama told reporters last Friday. "We take antibiotics for granted for a lot of illnesses that can be deadly or debilitating."

The World Health Organization also recognizes antimicrobial resistance as a global concern.

"Without urgent, coordinated action, the world is heading towards a post-antibiotic era, in which common infections and minor injuries, which have been treatable for decades, can once again kill," the organization said following its 2014 report on the subject.

Antibiotic resistance is the result of antibiotic overuse by patients, doctors and farmers, Edwards said, adding that we also need to develop new antibiotics. Even if one person, country or industry curtails their antibiotic use, it's not enough, she said.

"It has to be everybody or it's not going to work," Edwards said. "This is a problem, and it's becoming a bigger problem. It's something that until somebody does something about it, it's going to keep getting worse."