Gay and bisexual men have been warned today of a spike in cases of a superbug that spreads through sex.
Bosses at the UK Health Security Agency (UKHSA) said cases of an 'extensive' antibiotic-resistant version of Shigella sonnei in England have risen 24-fold in less than a year.
The intestinal infection can cause diarrhea, stomach cramps and fever. Some patients will need to be hospitalized.
Official data shows that 97 cases of the infection have been reported this year alone, up to the end of November. Only four were registered in 2022.
It also marks the highest annual number of cases of antibiotic-resistant Shigella since the pandemic began.
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Shigella bacteria contain a 'switch' protein called VirB, which causes the bacterium to cause serious gastrointestinal diseases in humans
The number of Shigella cases increased by 24 per cent in September (485), compared to the same period in 2019 (392), UKHSA data shows.
The rising figures are a reminder of the importance of testing for sexually transmitted infections (STIs), health chiefs have warned.
Every region in England has recorded at least one case of Shigella, she added. But fallen are concentrated in London (45), the northwest (21) and the southeast (12).
Most infected people are likely to have treatable symptoms of gastroenteritis.
However, antibiotic treatments are recommended in people with severe symptoms, including prolonged diarrhea, in those requiring hospitalization, or in those with an underlying immunodeficiency.
But the bug has become resistant to quinolones and azithromycin, two of the most common types of antibiotics ever used to kill the disease.
The infection is caused by bacteria in feces, which are usually spread through sex with anal contact.
But it can also be transmitted through unwashed hands, when infected people contaminate surfaces that others can touch, or when someone eats food contaminated with the bacteria.
Dr. Gauri Godbole, medical microbiologist at UKHSA, said: 'This is a worrying increase in the number of cases of this antibiotic-resistant strain, meaning treatment can be very difficult.
'One of the best ways to protect yourself and your partners is to practice good hygiene after sex.
'Avoid oral sex immediately after anal sex, alternate condoms between anal or oral sex and wash your hands with soap after sexual contact.
'It is important that gay, bisexual and other men who have sex with men do not ignore their symptoms and talk to their GP or sexual health clinic, mentioning Shigella, if they are feeling unwell.'
He recommended that men with Shigella get tested for other STDs, including HIV, because they may have been exposed to other infections.
Infected people should stay hydrated, rest and avoid sex until a week after their last symptoms, Dr. Godbole said.
They should also avoid all spas, swimming, hot tubs, and sharing towels, and avoid preparing food for other people until a week after symptoms have cleared.
But it's not just men who have sex with men that officials are concerned about regarding the spread of the Shigella strain.
While 90 per cent of cases recorded in 2023 were among men with an average age of 35, indicating 'a predominance of sexual transmission', UKHSA chiefs also warned of the dangers of foodborne infections.
The spread of the virus among food handlers and caregivers has previously caused outbreaks around the world by continuing to work when they are not feeling well, they said.
Symptoms usually begin within four days of exposure to the infection, but are often confused with food poisoning.