Use of gender distribution in routine surveillance data to detect potential transmission of gastrointestinal infections among men who have sex with men in England

Abstract

Detecting gastrointestinal (GI) infection transmission among men who have sex with men (MSM) in England is complicated by a lack of routine sexual behavioural data. We investigated whether gender distributions might generate signals for increased transmission of GI pathogens among MSM. We examined the percentage male of laboratory-confirmed patient-episodes for patients with no known travel history for 10 GI infections of public health interest in England between 2003 and 2013, stratified by age and region. An adult male excess was observed for Shigella spp. (annual maximum 71% male); most pronounced for those aged 25-49 years and living in London, Brighton and Manchester. An adult male excess was observed every year for Entamoeba histolytica (range 59.8-76.1% male), Giardia (53.1-57.6%) and Campylobacter (52.1-53.5%) and for a minority of years for hepatitis A (max. 69.8%) and typhoidal salmonella (max. 65.7%). This approach generated a signal for excess male episodes for six GI pathogens, including a characterised outbreak of Shigella among MSM. Stratified analyses by geography and age group were consistent with MSM transmission for Shigella. Optimisation and routine application of this technique by public health authorities elsewhere might help identify potential GI infection outbreaks due to sexual transmission among MSM, for further investigation.

Ongoing transmission of Entamoeba histolytica among newly diagnosed people living with HIV in Taiwan, 2009-2018

“…In an outbreak of intestinal amoebiasis in Spain, two out of eight patients had concurrent shigellosis [11]. In two epidemiologic investigations from Canada and the United Kingdom, a higher male-to-female ratio of amoebiasis, shigellosis, and giardiasis among individuals of sexually active age groups were observed [29,30]. In our study, patients with invasive amoebiasis were more likely to have concurrent enterically transmitted infections (8.4% vs 2.2%).…”

International Spread of Multidrug-Resistant Campylobacter coli in Men Who Have Sex With Men in Washington State and Québec, 2015–2018

“…We note that of the Washington State isolates, only Campylobacter sequenced from MSM yielded additional cluster isolates when interrogating NCBI databases. Although gender was not available for these additional isolates identified via genomic epidemiology, a skewed gender distribution of enteric infections has been suggested as a possible sign of enteric outbreaks among MSM in major metropolitan areas in the United Kingdom [ 41 ]. In addition to Shigella , a male skew for non-travel-associated enteric infections was found for Campylobacter [ 41 ].…”

COP9 signalosome is an essential and druggable parasite target that regulates protein degradation

“…Multiple areas across the world continue to observe prevalence rates of amebiasis of over 10% [14]. Commonly considered an infection of poor countries spread by fecaloral transmission, however, immigration, travel, and sexual transmission are leading to reemergence of amebiasis in developed settings [16][17][18][19][20][21][22][23][24][25]. There is no vaccine and only one class of drugs (nitroimidazoles) available to effectively treat invasive forms of disease.…”