Doctors raise alarm about gastrointestinal disease caused by drug-resistant Shigella bacteria

CHICAGO (CBS) -- A surge in stomach flu cases has the Centers for Disease Control and Prevention issuing a warning - with a drug-resistant strain of one bacterial infection becoming more common.

Despite its colloquial name, "stomach flu" is not a form of influenza. It can be caused by a viral infection with the norovirus – a pathogen that has also been surging in the Chicago area and well beyond lately.

But the concern now is a bacterial gastroenterological infection caused by an organism that has been exhibiting drug resistance.

As CBS 2's Tara Molina reported, doctors say for the most part, people can fight off such infections on their own. But the drug resistance is a big concern.

"We are seeing a lot of norovirus, or stomach flus, coming in," said Northwestern Memorial Hospital ER physician Dr. Evelyn Huang. "People will come in, and they are so dehydrated that they no longer can keep anything down."

Symptoms include fever, diarrhea, and stomach pain. But Dr. Huang said for the most part, with both the norovirus and the bacterial infection Shigella, most people can fight off the infections on their own at home.

"It's not new," she said. "We see it every year."

But the concerns about antibiotic resistance indeed are new. Shigellosis is an illness you've probably seen headlines on by now because the Centers for Disease Control and Prevention is warning about a drug-resistant strain of the Shigella bacterium - urging health care providers to be cautious when prescribing antibiotics because it could encourage resistance.

Dr. Huang called it a priority for Northwestern, and said not to be surprised if you're not prescribed antibiotics for something you may have been in the past – a Shigella infection included.

"We want to reserve the antibiotics for people who have severe cases or who are immunocompromised," Huang said.

In Chicago, there have been three total cases of the antibiotic-resistant strain of Shigella reported. Three were among men who have sex with men, and one was an out-of-state case reported after travel to the Chicago area.

Statewide in Illinois, there have been six cases of drug-resistant Shigella out of 239 reported nationally. They have been reported in 29 states – also including California (76), Colorado (36), Massachusetts (34), Texas (15), Nevada (seven), Rhode Island (seven), Utah (Seven), Indiana (five), Minnesota (five), and New York (five).

A spokesperson for the city's Department of Public Health said both in Chicago and nationally, the people where they've tracked an increase are gay and bisexual adults, people experiencing homelessness, international travelers, and people living with HIV. This is the CDPH's full statement:

"The Chicago Department of Public Health (CDPH) has been monitoring an increase in extensively drug-resistant (XDR) Shigella infections reported from clinicians and laboratories.

"Nationally and in Chicago there has been an increase in antimicrobial-resistant Shigella infections among adults; especially among: Gay, bisexual, and other men who have sex with men (MSM), People experiencing homelessness, International travelers, and People living with HIV. Clinicians treating patients infected with XDR shigella strains have limited antimicrobial treatment options. Shigella bacteria are easily transmissible. XDR Shigella strains can spread antimicrobial resistance genes to other enteric bacteria. Clinicians should be aware of this circulating drug-resistant strain of Shigella, follow up with patients diagnosed with Shigella infections to ensure symptom resolution, and ensure that antimicrobial susceptibility testing is performed on Shigella isolates, particularly in the case of treatment failure. CDPH asks healthcare professionals to be vigilant about suspecting and reporting cases of XDR Shigella infection to their local or state health department and educating patients and communities at increased risk about prevention and transmission.

"CDPH coordinates clinicians education and testing for XDR Shigella infection. CDPH staff also conducts interviews to assess exposure risks, and provides education for prevention and resources to individuals identified with Shigella infection. For additional information, see attached."

Dr. Huang reiterated that most people can fight off what's going around right now at home.

"As long as you are staying hydrated, resting when you can, and staying away from others while you're sick, you should be just fine," she said.

A spokesperson for Cook County Public health said there are no known outbreaks across the county, but they have seen a slightly higher than usual number of Shigella cases.

This is the official warning from the CDC:

This is a health alert from the CDPH:

In:
• Northwestern Memorial Hospital