Headlines this week claimed shigellosis — the diarrheal illness caused by Shigella bacteria — was 'surging' or 'exploding' across the United States, driving a spike in searches for 'is sexually transmitted diarrhea a thing?' According to USA Today, CDC data tells a calmer story: 13,921 Americans had been diagnosed with shigellosis as of Sept. 26, 2026, a rate that appears on par with last year's total of 14,277 cases. The current buzz appears to stem from one or two outlets revisiting earlier reporting and reigniting public interest online.

The renewed alarm traces to the CDC's April report on extensively drug-resistant (XDR) Shigella, which found resistant isolates rose from 0% of tested samples between 2011 and 2015 to 8.5% in 2023. USA Today notes that report and related studies have been published over the last couple of years, including one this summer, but no new outbreak underlies this week's coverage. Health experts still call drug-resistant shigellosis a serious public health issue that deserves more attention — the problem is the framing, not the facts.

The underlying science remains sobering even if case counts are stable. The CDC analyzed nearly 17,000 Shigella isolates collected from 2011 through Oct. 20, 2023, and classified 510 — 3% — as extensively drug-resistant, meaning resistant to five common antibiotics: ampicillin, azithromycin, ceftriaxone, ciprofloxacin and trimethoprim-sulfamethoxazole. Most XDR cases occurred in 2022 and 2023, which together accounted for 415 cases, or more than 84% of the total. Nearly 96% of patients with available age and sex data were adults, and 86.2% were men, with a median age of 41.

There are no FDA-approved oral antibiotics specifically available to treat XDR Shigella infections, so doctors may need laboratory susceptibility testing to determine which medications, if any, are likely to work. Of the 258 patients with hospitalization information in the CDC analysis, 97 — 37.6% — were hospitalized, though no deaths were reported. USA Today reports that certain communities, including unhoused people and children under age 5, face especially high risk, and people with weakened immune systems, including those living with HIV, may face more severe illness and fewer treatment options.

Shigella is highly contagious — infection can occur after exposure to as few as 10 organisms — and spreads through fecal-oral contact, contaminated food or water, and sexual contact. Previous studies have identified sexual contact among men who have sex with men as an important transmission route, and USA Today notes resistant strains are more prominent in that community. A UK study in The Lancet Infectious Diseases found about 70% of sexually transmissible Shigella strains were resistant to at least one antibiotic by the end of its 2015–2020 study period, versus 40% of non-sexually transmitted strains.

The CDC urges clinicians to order antimicrobial susceptibility testing when possible and report cases promptly, and says improved surveillance and targeted prevention will be needed to limit drug-resistant strains. For individuals, the CDC recommends thorough handwashing with soap and running water after using the bathroom, before handling food, and before and after sex; avoiding swallowing water when swimming; and avoiding sex — and waiting at least two weeks after diarrhea symptoms stop — if you or a partner have been sick. People with symptoms should also skip preparing or sharing food and stay out of pools and natural bodies of water.