Update: Shigella Outbreak in San Diego County — 11-19-2021

Picture of shigella bacteria

The County of San Diego has announced three new shigella cases associated with an ongoing outbreak, bringing the total to 38 confirmed and three probable cases among people experiencing homelessness.

The continuing investigation shows onset of illness dates between Aug. 16 and Nov. 8, 2021, with the four new cases occurring between Oct. 23 and Nov. 8, 2021. The 41 cases in this outbreak represent 11% of the 349 total cases reported to date in San Diego County.

The cases are primarily among individuals experiencing homelessness, with the majority at multiple locations in central San Diego. A case with a known address outside the City of San Diego is being investigated to determine where that individual was residing when they contracted the disease. No source of the outbreak has currently been identified.

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

  • Prevent any future potential exposure sites.
  • Promote good hygienic precautions among homeless service providers and food providers.
  • Connect ill individuals to treatment and housing.

Other steps have included:

  • Relocation of 32 currently deployed handwashing stations and placement of 16 new handwashing stations to areas frequented by homeless individuals. Evaluation of additional need is ongoing.
  • Increased cleaning of portable and permanent public bathrooms.
  • Placement of 8 new portable restrooms by the City at three locations in in Downtown, Pacific Beach and Rolando Village. Other sites continue to be evaluated.
  • Increased sidewalk sanitization from twice weekly to seven days per week for the time being. Frequency will be continually assessed.
  • Launch of new “sidewalk reset” pilot program by City that allows for a deeper cleaning of sidewalks to remove build up and make regular sanitization efforts more effective. The process is being implemented in several areas including Downtown, Beach Areas and South Bay, with others being evaluated.
  • Notification by the County Department of Environmental Health and Quality about the outbreak – and precautions – to food facilities in the downtown, Mission Valley and Hillcrest areas, charitable feeding operators, the California Restaurant Association, Downtown San Diego Partnership, Regional Task Force on Homelessness and Gaslamp Quarter Association.
  • Public health nurses conducting outreach at shelters.
  • Homeless Outreach Teams offering shelter resources and distributing weekly 1,000 hygiene kits with shigella information to persons experiencing homelessness.
  • Creation of County Public Health shigella website with outbreak information.

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 of shigellosis 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. The next regularly scheduled shigella outbreak news release will appear Friday, Dec. 3. Updated information will remain available on the County Public Health shigella website.