England reports sustained increase in sexually transmitted shigellosis (S. sonnei, S. flexneri) among men who have sex with men (MSM) (25% increase from 2023 to 2025, and similar trend in 2026). Half of the cases are reported in London.
The outbreak features high antimicrobial resistance, with over half of S. sonnei isolates resistant to all three first-line treatments (ciprofloxacin, azithromycin, ceftriaxone), severely restricting options for serious cases and raising concerns about continued transmission within international sexual networks.
Raising awareness of the threat of sexual transmission of XDR Shigella and other enteric pathogens and how to reduce the risk is particularly important considering upcoming Pride events and other MSM festivals in the spring and summer.
Clinical services likely to provide care for MSM with Shigella infection should be aware that they may be at higher risk of infection with strains resistant to many commonly used antimicrobial agents.
For travellers at risk of exposure:
Respect safer sex rules (Love Live). This includes using condoms every time you have sex.
See STI factsheet, for more detailed information.