在英國的男同性戀和雙性戀男性中志賀氏痢疾桿菌是一種性病，但你聽說過嗎？
資料來源：菲爾·桑巴， / https://www.gaytimes.co.uk/， 財團法人台灣紅絲帶基金會編譯
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您可能聽說過更常見的性傳染病感染 (STI)，例如淋病、衣原體和梅毒。您甚至可能知道症狀是什麼以及如何接受治療。但是你聽說過志賀氏痢疾桿菌嗎？
我們大多數需要了解它的人要麼沒有聽說過，要麼對它知之甚少，要麼不知道它是如何引起、診斷、治療或預防。
志賀氏菌是一種導致腸道感染的細菌，其症狀包括感覺不適、嚴重腹瀉、嘔吐、腹痛和發燒。由於症狀相似，常被誤認為是食物中毒。
它通常是在與無意間攝入糞便的人發生性關係時被發現的，尤其是通過肛吻。您可以透過插入性行為、指交、拳交或共享性玩具而感染它，因為您的手上可能有少量細菌或某些東西最終進入您嘴裡。如果在處理保險套時細菌從您的手傳播到您的嘴，那麼志賀氏菌就會傳播。出國旅行時，也可能從受污染的水和食物中獲得感染。
症狀在接觸後 1 到 4 天內開始，持續 3 到 7 天，但可能需要更長時間。在某些情況下，症狀會導致住院。
只需要少量的細菌就可以讓你感到不適
一種誤解是，大量細菌被攝入時會變差，但志賀氏菌只需要非常少量的細菌即可傳播。性不一定要「雜亂」才能被傳遞。有些人攜帶它也沒有任何症狀。
病情可能很嚴重
症狀可能是身體無法動彈，已經康復的人可能在幾週內感覺不會好轉。
許多患有這種疾病的人都對自己的病情感到震驚，稱這是他們有史以來病得最嚴重的一次。有些人的腹瀉含有血液或粘液，這可能會令人不安。
症狀可以自行消失
不是每個人都需要治療，因為症狀可以在一周內解決。但是，如果您病重，您應該去看臨床醫生以獲得正確的治療以清除感染。
如果您在約炮後出現嚴重的腹瀉病症，請聯繫您的性健康診所或您的家庭醫生，並解釋您已經發生過性行為並且您的症狀與志賀氏菌相符。
有脫水的風險
如果您經常腹瀉，請多喝水以補充流失的液體並防止您脫水。嘗試喝大量的水、果汁和運動飲料來取代流失的鹽和礦物質。
服用止痛藥，如撲熱息痛，可以幫助緩解疼痛和發燒，但建議避免服用抗腹瀉藥物，如 Imodium，因為它們可能會使情況變得更糟。
志賀氏菌對抗生素非常有抵抗力
症狀可能會很快消失，但如果您的病例持續時間超過幾天，則應該由您的性健康診所或您的家庭醫師給您開一個短療程的抗生素。但是，志賀氏菌對某些抗生素的耐藥性越來越強，因此您可能需要提供糞便樣本才能進行正確的測試和抗生素投藥。
您可能接觸過其他性傳染病感染
如果您的性行為使您面臨感染志賀氏菌的風險，您可能已經接觸過其他性傳染病感染。無論您的愛滋病毒狀況如何，在診斷出志賀氏菌後，建議您在診所或通過在線訂購測試進行全面的性健康檢查。詢問 U=U、PrEP 和其他性傳染病的疫苗，例A型肝炎、B型肝炎和 HPV。
最好在志賀氏菌的最後症狀結束後 7 天之前避免性行為，以避免將其傳染給他人。
你可以避免傳播它
您有可能將其傳播給與您同住或與您有密切（非性）接觸的人。盡量減少與其他人的密切接觸，避免共用毛巾和面巾，並在盡可能高的溫度下洗衣服。
全天定期用肥皂和熱水洗手，尤其是在上完廁所後，在處理、進食或烹飪食物，或處理嬰兒和餵養幼兒或老人之前也要這樣做，以避免傳播。
你可以通過保持衛生來預防志賀氏菌
為此，請避免在肛交後或肛交開始後再次進行口交，尤其是與新伴侶在一起時。肛交、指交和拳交也會增加您的風險，但您和您的伴侶可以透過在肛交後或肛門活動後用肥皂和熱水洗手、清洗臀部和生殖器來降低風險。
Shigella is an STI increasing among gay and bi men in the UK – but have you ever heard of it?
BY PHIL SAMBA/ https://www.gaytimes.co.uk/
You may have heard of more common sexually transmitted infections (STIs) such as gonorrhoea, chlamydia, and syphilis. You might even know what the symptoms are and how to get treatment. But have you heard of Shigella?
Most of us who need to know about it either haven’t heard of it, know very little about it, or don’t know how it is caused, diagnosed, treated or prevented.
Shigella is a bacterium that causes a gut infection with symptoms ranging from feeling sick, severe diarrhoea, vomiting, abdominal pain, and fever. As symptoms are similar, it’s often mistaken for food poisoning.
It’s typically caught from having sex with someone who is infectious by unintentionally ingesting faeces (poo), especially through rimming. You can get it from having penetrative sex, fingering, fisting, or sharing sex toys as there might be small amounts of bacteria on your hands or things that end up in your mouth. Shigella can be transmitted when handling condoms if bacteria travels from your hands to your mouth. It can also be caught from contaminated water and food when travelling abroad.
Symptoms begin within one to four days of exposure and last three to seven days, but can take longer. In some cases, symptoms lead to hospitalisations.
It only takes a small amount of bacteria to make you unwell
A misconception is that lots of bacteria are ingested to become poorly but it only takes a very tiny amount of bacteria for Shigella to be transmitted. Sex does not have to be “messy” for it to be passed on. Some people carry it without any symptoms, too.
The illness can be quite severe
Symptoms can be physically immobilising, and people who have recovered from it may not feel better for a couple of weeks.
Many people who have had it were shocked at just how sick they became, describing it as the most ill they have ever been. Some people have diarrhoea containing blood or mucus, which can be unsettling.
Symptoms CAN go away on their own
Not everyone needs treatment as symptoms can settle within a week. However, if you become seriously ill you should see a clinician to get the right treatment to clear the infection.
If you have a bad case of diarrhoea after a hook-up, contact your sexual health clinic or your GP and explain that you’ve had sex and your symptoms match Shigella.
There’s a risk of dehydration
If you have frequent diarrhoea, drink lots of fluids to replace those lost and stop you from becoming dehydrated. Try drinking plenty of water, fruit juices and sports drinks that replace salts and minerals.
Taking painkillers, such as paracetamol, can help to relieve pain and fever, but it’s advised to avoid anti-diarrhoea medicines, such as Imodium, because they may make things even worse.
Shigella can be VERY resistant to antibiotics
Symptoms could clear up quickly, but if you have a particularly persistent case lasting longer than a few days, you should be prescribed a short course of antibiotics by your sexual health clinic or your GP. However, Shigella is becoming more resistant to some antibiotics, so you may have to give a stool sample to get the right tests and antibiotics.
You could have been exposed other STIs
If you’ve had sex that puts you at risk of Shigella, it’s possible that you might have been exposed to other STIs. Regardless of your HIV status, after a Shigella diagnosis it’s advised to have a full sexual health check-up at a clinic or by ordering tests online. Enquire about U=U, PrEP, and vaccines for other STIs, such as hepatitis A, hepatitis B, and HPV.
It’s best to avoid sex until seven days after your last symptom of Shigella ends to avoid passing it on to others.
You can avoid passing it on
It’s possible to transmit it to people you live with, or with whom you have close (non-sexual) contact. Keep close contact with anyone else to a minimum, avoid sharing towels and facecloths, and wash your laundry on the highest setting possible.
Wash your hands with soap and hot water regularly throughout the day, especially after using the toilet and do the same before handling, eating or cooking food, or handling babies and feeding the young or the elderly to avoid transmission.
You can prevent Shigella by practising hygiene
To do this, avoid going back to oral sex after anal sex or anal play has started, especially with new partners. Rimming, fingering and fisting also increases your risk, but you and your partners can lower it by washing your hands, bum and genitals with soap and hot water after having anal sex or anal play.