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Two enteric disease outbreaks concurrently affect MSM in Minnesota
Concurrent outbreaks of shigellosis and cryptosporidiosis occurred among men who have sex with men in Minnesota, according to a brief report published in Clinical Infectious Diseases.
Eight men developed illness related to Shigella flexneri serotype 3a from Nov. 8 to Feb. 23. All of the cases were MSM and four of the patients had HIV. Five patients were hospitalized for 1 to 6 days. All of the men were from the Minneapolis-St. Paul area. The cases had no epidemiologic links or known contact with each other, and seven of the isolates were indistinguishable by pulsed-field gel electrophoresis (PFGE). During the same time frame, there were four other non-related cases of S. flexneri 3a.
From Nov. 1 to Jan. 28, eight MSM with HIV developed illness related to Cryptosporidium hominis. Two patients were hospitalized for 4 and 9 days. All of the men were from the Minneapolis-St. Paul area. There were no common food, water or animal exposures. The C. hominis subtype IfA12G1R2 was found in the stool specimens of all the cases. The subtype has previously been identified in less than 1% of C. hominis isolates among Minnesota residents. The cases in this outbreak were not related to the cases in the concurrent shigellosis outbreak.
According to the report, both diseases have been associated with MSM in the past.
“The outbreaks presented here are a reflection of the ongoing sustained increased incidence seen in the United States of syphilis and gonorrhea among MSM, the large proportion of whom are also coinfected with HIV,” the Minnesota Department of Health investigators wrote. “Prevention messages for MSM, including those who are known to be HIV-infected, must go beyond an emphasis on HIV treatment as prevention and continue to include the risk of other sexually transmitted diseases including enteric diseases transmitted through sexual contact.”
Disclosure: The researchers report no relevant financial disclosures.