Extensively Drug-Resistant (XDR) Shigella Sonnei Infections Breaking Out In India Since Late April 2022?
Local doctors in Kerala first identified cases involving two kids who suffered Shigella
Sonnei Infections in late April 2022. https://www.thehindu.com/news/national/kerala/top-kerala-news-developments-on-april-28-2022/article65362519.ece
The two children died as they did not respond to a variety of existing antimicrobials and local doctors reported to the health authorities that they believed a strain of extensive drug resistant Shigella
Sonnei was in circulation. Their deaths were strangely never reported to the media.
In early May 2022, 58 individuals contracted the disease in Kasaragod-Kerala and a young girl died from the disease.
In another case that involved a student in Thrissur, Kerala, despite media coverage and claims by local health authorities that the more surveillance would be put into place and preventive measures imposed, nothing was really done. https://www.thehindu.com/news/national/kerala/shigella-cases-confirmed-in-thrissur/article65463047.ece
As a result, more than 23 other students contracted the disease and at least 3 died from it as a result of no existing antimicrobials being able to treat them.
To date, despite warnings by many local doctors and specialists that an extensively drug-resistant (XDR) or multi-drug resistant (MDR) shigellosis is spreading in India, authorities are not responding and are actually imposing media blackouts of all such cases, apparently instructed by state politicians.
As a result of no proper actions being taken, to date more than 206 such infections have been registered all over in Kerala and 13 deaths have occurred with new cases also appearing in the states of Karnataka and Tamil Nadu.
Local health authorities suspect that there could be far more cases as many hospitals and clinics do not report such cases to the proper registers.
In almost 68 percent of cases so far, patients had severe conditions and required hospitalization.
Extensively drug-resistant (XDR) and multi-drug resistant (MDR) Shigella sonnei infections are a public health concern since treatment options are very limited for moderate to severe cases. https://www.who.int/emergencies/disease-outbreak-news/item/2022-DON364
Shigellosis is a disease is caused by the Shigella bacteria and is a gastrointestinal infection, and symptoms include abdominal cramps, diarrhea that sometimes contains blood, nausea, vomiting, and fever. Shigella sonnei has a very low infectious dose, and
the infection may spread from person to person or via contaminated objects, food, or water.
Symptoms usually begin 1–2 days after infection and last 7 days. Most people recover without needing antibiotics.
However, in moderate and severe cases, treatment with antibiotics is the only solution.
The WHO recommends that clinically diagnosed cases of Shigella dysentery be treated with ciprofloxacin as first line treatment, and pivmecillinam, ceftriaxone, or azithromycin as second line treatment and lists the other antibiotics as ineffective (WHO 2005a). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6532574/
However, when treatment with antibiotics fail, then it is typically assumed that Extensively drug-resistant (XDR) and multi-drug resistant (MDR) strains could be at play and such incidences should typically be reported to the WHO.
However, to date, Indian health authorities have not made any such report while cases are still emerging.
Local doctors in Kerala are worried that the extensive use of antibiotics during the last COVID-19 surges could have led to the emergence of such drug resistant strains and furthermore, with more Post COVID individuals having a dysregulated immune system, such pathogenic infections could result in more severe conditions for them.
Thailand Medical News
will provide more updates on the Extensively Drug-Resistant (XDR)Shigella Sonnei Infections occurring in India. (With help of local doctors in Kerala.)