Drug-resistant shigella among queer men

[CheckCar]

heads-up on the spread of a drug-resistant strand of shigella among queer men

https://www.advocate.com/health/sexual-health/what-is-shigella#rebelltitem2

 

[+ Vegas_Millennial]

From the article: 

“With the rise of group sex in bath houses, dark rooms, and sex parties, I feel that there is a lack of understanding that you can get it from giving head to someone who just plowed someone else without protection and without cleaning off effectively or from being penetrated by someone rectally in the same scenario,” Thomas says. “This happens way more than people think."

Yet another reason I prefer to be the only bottom at an orgy/gangbang.  People may call me a greedy bottom, but at least I don't have to worry about cross contamination from any other bottom in the room. 🎉 💩 

Edited Tuesday at 02:53 AM by Vegas_Millennial

[+ purplekow]

If you are taking it from more than one top and he is hitting bottoms around the room, you can definitely be infected if he is not cleaning off between bangs.  So the wise thing is to make sure he is cleaned off properly, use a condom, or not participate in these activities.  As the last two are unlikely, you need to ensure that he has cleaned up and the best way to do that is to clean him yourself with an antibacterial soap and a thorough wash and dry.  

Edited Tuesday at 09:43 AM by purplekow

[+ PhileasFogg]

Well so much for tonight’s foursome 😳

[mike carey]

If a foursome is out of the question, perhaps Stableford or four ball best ball?

[jeezifonly]

I guess, for the time being, my lips are sealed. All of 'em...

[+ nycman]

5 hours ago, jeezifonly said:

I guess, for the time being, my lips are sealed. All of 'em...

In the grand tradition….

I feel a song coming on:

 

[+ PhileasFogg]

On a serious note, I’ve never heard of shigella until this post (and last night’s foursome proceeded as planned)

But, while I understand that symptoms can be severe for compromised people, how serious is this?   If an antibiotic resistant strain in contracted, my research indicates that it will still run its course in days.  While this doesn’t sound pleasant, isn’t it manageable?

[+ SirBillybob]

Shigellosis case incidence by general-population in my city is estimated at about 1 in 10,000-20,000 annually. Quantifying by MSM subpopulation denominator is not easily ascertained but it is disproportionately greater and there can be transmission clusters like for any susceptible group. Computed risk by specific behaviour in probability terms remains elusive. 

But if infection occurs, the chance that the strain is extensively drug resistant appears to be hovering around 10% based on 2023 surveillance data as reported in the MMWR piece, with proportions rising since the mid-2010s. It is reasonable to extend the upward trajectory trend since then and going forward. However, the gen pop incidence of the now two main identified strains of elevated concern together amounts to about 1 per 100,000 by simple arithmetic. 

Hospitalization rates in the MMWR report were roughly one in three. Since no FDA-approved oral drug treatment exists for the extensively resistant strains, the precise role of hospitalization is somewhat opaque, supportive management versus attempts at salvage regimens still under evaluation. 

We are seeing accelerating prevalence velocity in a disease variant that remains relatively rare in probability terms, yet still carries a meaningful chance of making one sick enough to occupy a hospital bed. Those few won’t proclaim it’s much doo-doo about nothing. 

 

Edited Wednesday at 06:53 PM by SirBillybob

[+ SirBillybob]

10 hours ago, PhileasFogg said:

On a serious note, I’ve never heard of shigella until this post (and last night’s foursome proceeded as planned)

But, while I understand that symptoms can be severe for compromised people, how serious is this?   If an antibiotic resistant strain in contracted, my research indicates that it will still run its course in days.  While this doesn’t sound pleasant, isn’t it manageable?

You have identified the need to consider three separate issues, as well as possibly implications for how much reassurance to derive from: overall spontaneous clinical resolution prospects; specific AMR strain clearance potential compared to non-AMR; and judicious (even restrained) use of antibiotics, despite resistance risk, across a range of symptom severity and persistence. 

We know clearly neither whether AMR cases are equally self-limited nor whether or how much the subset of overall shigella cases that is severe enough to seek/need antibiotics overlaps with the subset least likely to respond to standard antibiotics. The pinch point clinically is the subset that is severe enough to warrant antibiotics or hospitalization (or both), but precisely where drug resistance matters most. Acquiring day passes for orgies is unlikely. 

Thus, the wording that asserts high frequency of overall self-limited disease and the notion that the trend of increasing proportions of drug resistance is consequential are not contradictory. They describe different slices of case distribution.

Our mission, should we choose to accept, is to reduce fecal drift. Your point about transient infection is well taken, though, as annual case numbers reflect mostly spontaneous resolution and brief windows of transmissibility. 

Edited Wednesday at 10:27 PM by SirBillybob

[Luv2play]

I contracted shigella 25 years ago and went to the gay clinic in Montreals Village. The doctor prescribed the wrong treatment as he thought it was something else. I had misgivings as I had read up on it before going to see him.

Within a few days my symptoms were not lessening and I shortly went back and saw a different doctor. After explaining my apprehensions she reviewed my case and even before waiting for test results switched the medication to treat the shigella. It cleared up in a few days.