The health authority is now updating its recommended protocols for combating potentially dangerous bacterial infections.
Shigella is a bacterium that infects the intestines and is usually spread through the fecal-oral route. This means that it can be transmitted when mouth-to-mouth contact with something such as food or a finger with feces contaminated with Shigella.
Symptoms of shigellosis include persistent diarrhea, bloody stools, stomach cramps, vomiting, and fever.
For most people, the infection clears up on its own with rest and drinking plenty of water. But infections can lead to hospitalization, as was seen in Edmonton where there were 172 confirmed cases as of Wednesday and 115 hospitalized.
In Edmonton, the outbreak began in August and has had a significant impact on the homeless population, as the bacteria appear to be spread via contaminated surfaces, food or water.
Sexually transmitted bacteria
But Montreal authorities are finding that multidrug-resistant strains of bacteria are circulating locally, especially among men who have sex with men.
As of September 30, 25 of the 56 infections were caused by multidrug-resistant strains and spread mainly through sexual transmission. Six of those 25 required hospitalization.
Almost all MDR infections have been found among MSM, and only six of the 25 drug-resistant cases were contracted overseas, “suggesting a predominance of local transmission,” according to Montreal Public Health. in the current situation.
Just over 40 percent – or 11 of 25 – of these drug-resistant cases were from sexual activity with anonymous partners, the statement said.
One in four infections has been in people such as healthcare workers or food handlers who have a high risk of spreading it further.
Being multidrug resistant means that a bacterial infection is resistant to at least three classes of clinically useful antibiotics. Montreal Public Health says several strains of shigella have acquired multidrug resistance.
The health authority says several European countries and the United States have reported large and ongoing outbreaks due to multidrug-resistant strains, particularly among men who have sex with men.
The Montreal Health Authority makes recommendations
Contaminated food used to be the primary means of transmission and only recently has sexual transmission become an issue, says Dr. Christopher Labus, a cardiologist and epidemiologist at McGill University.
Lapus said that taking an antibiotic for three days like ciprofloxacin (Cipro) used to be the first treatment, but now those drugs don’t always work and that leads to some anxiety.
Unless new antibiotics are developed to combat these drug-resistant organisms, “we may start to have a problem,” Lapus said.
“Diseases that were once easy to treat can become much more complex.”
Among its recommendations, published on Monday, the Health Authority said that doctors should wait for the result of an antibiotic examination that reveals the sensitivity of bacteria to a variety of antibiotics, before starting treatment if the patient’s condition allows for this delay.
The health authority says people who work in the food, daycare and health care sectors must be pulled from a job until they have tested negative twice 24 hours apart.
Along with good hand hygiene, health authorities suggest using a protective barrier, such as a condom or disposable gloves, during sexual activity.
Health authorities recommend washing your hands, genitals and anus before and after sex. Bacteria can also be transmitted through sex toys, so Montreal Public Health says they should be kept clean, too.
The NHS says people should abstain from sex if they have diarrhoea. People infected with shigellosis should abstain from sex for three to four weeks after symptoms resolve.
For those who are prescribed antibiotics, Montreal Public Health says patients should finish the entire course even if symptoms clear up.