Health

Shigella Outbreak Update for People Experiencing Homelessness

Picture of shigella bacteria

The County of San Diego has announced 11 new shigella cases associated with an ongoing outbreak, bringing the total to 15 confirmed and three probable among individuals experiencing homelessness.

The continuing investigation shows onset of illness dates between Aug. 16 and Oct. 14. The 18 cases in this outbreak represent 6.8 percent of the 266 total cases reported to date in San Diego County.

The cases are all among individuals experiencing homelessness who resided at multiple locations in central San Diego. No source of the outbreak has currently been identified.

The County is working closely with the City of San Diego to:

  • Identify potential exposure sites.
  • Promote good hygienic precautions among homeless service providers and food providers.
  • Identify additional cases.
  • Connect ill individuals to treatment and housing.

Other steps include:

  • Relocation of currently deployed handwashing stations to areas frequented by homeless individuals and evaluation of need for additional stations.
  • Increased cleaning of portable and fixed public bathrooms.
  • Increased sidewalk sanitization from twice weekly to seven days per week for the time being. Frequency will be continually assessed.
  • Notification by the County Department of Environmental Health and Quality about the outbreak – and precautions – to food facilities in the downtown area, charitable feeding operators, the California Restaurant Association, Downtown San Diego Partnership and Gaslamp Quarter Association.
  • Public health nurses conducting outreach at shelters.
  • Homeless Outreach Teams distributing Shigella information as part of hygiene kits given to persons experiencing homelessness, including an extra 600 the week of Oct. 18.

Shigella is a contagious infection typically spread by contaminated surfaces, food or water, or person-to-person. Those at increased risk include young children (especially those in daycare), people who are experiencing homelessness, travelers to locations with poor sanitation, and men who have sex with men. In 2020, a total of 240 shigellosis cases were reported in San Diego County residents while the 426 cases reported in 2019 was the highest since 1995.

Typical symptoms include diarrhea (sometimes bloody), fever and stomach cramps. While most people will recover fully without antibiotic treatment, some individuals with poor immune systems can develop life-threatening disease and may need further treatment.  People with symptoms that resemble shigella should contact their medical care provider. The provider may order stool testing to help with the diagnosis.

Strategies to avoid getting or spreading shigella include frequent hand washing and not preparing food while ill with diarrhea.

More information about shigella and precautions are available through the County, a California Health Alert Network notification and the Centers for Disease Control and Prevention.