UAE: Doctors urged to be on alert for drug-resistant Shigella infection after rising global cases

The WHO underlined that the drug-resistant infection as a “public health concern”

Ashwani Kumar

Published: Tue 26 Apr 2022, 7:29 PM

Last updated: Tue 26 Apr 2022, 10:28 PM

In a new circular, local health authorities in Abu Dhabi have urged healthcare providers in the Emirate to remain vigilant about drug-resistant bacteria infection.

The Department of Health – Abu Dhabi (DoH) and Abu Dhabi Public Health Centre (ADPHC) has recently issued a circular after the World Health Organisation (WHO) noted an unusually high number of cases of extensively drug-resistant (XDR) Shigella sonnei in European countries.

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“Cases have been reported in the UK and Northern Ireland, and several other countries in the WHO European Region since late 2021,” the WHO said in its notification on March 24.

The WHO underlined that the drug-resistant infection as a “public health concern”.

“Although most infections with S. sonnei result in a short duration of disease and low case fatality, multi-drug resistant (MDR) and XDR shigellosis is a public health concern since treatment options are very limited for moderate to severe cases,” WHO said.

‘Be more vigilant’

In its circular to healthcare service providers in Abu Dhabi, the authorities said that based on the limited information, the likelihood of spread of the disease from Europe is high.

“All healthcare professionals must be more vigilant about managing any suspected or confirmed MDR or XDR Shigella Sonnei infection, and should pay attention to people at risk of contracting the infection and travellers to high-risk areas.”

Shigella can be transmitted through the faecal-oral route by direct or indirect contact, sexual contact with infected person, contact with faeces from an infected person, or indirect contact such as by flies, fomites, consumption of contaminated food or water. Asymptomatic carriers can also transmit the disease.

Healthcare providers have been urged to report any suspected or confirmed cases of infection to the DoH or ADPHC.

Common symptoms

According to the WHO, shigellosis is a gastrointestinal infection caused by one of four species of Shigella bacteria, including S. sonnei. It is a virulent pathogen with a very low infective dose, which means that only a small number of bacteria, approximately 10 to 100 organisms, is sufficient to cause disease. Humans are the only known reservoir and can excrete bacteria in stool for weeks after bloody diarrhoea.

Dr Kumaraswamy, specialist, internal medicine, Medeor Hospital, Abu Dhabi, said diarrhoea, fever and stomach cramps are common symptoms seen in an infected person.

Dr Kumaraswamy

“The most common symptoms of this disease are watery or bloody diarrhoea, abdominal pain and cramps, fever, nausea, vomiting, loss of appetite, headache and discomfort.”

While most infections with S. sonnei result in a short duration of disease, with recovery within a week and low case fatality rate, this is not always the prognosis for immunocompromised cases and complications can occur.

‘Maintain good hygiene’

Shigellosis is endemic in most low- or middle-income countries and is a major cause of bloody diarrhoea worldwide. Each year, it is estimated to cause at least 80 million cases of bloody diarrhoea and 700,000 deaths.

Dr Kumaraswamy urged community members to follow good personal hygiene measures to protect themselves.

“People can wash their hands often with soap and running water. Proper handling of food is essential along with other hygienic measures to stay protected from infection,” Dr Kumaraswamy added.

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