San Diego County Government: Update on Shigella Outbreak in San Diego County – 10/21-2021


San Diego County has announced three new cases of shigella associated with an ongoing outbreak, bringing the total to 18 confirmed cases and three probable cases among people who are homeless.

The ongoing investigation shows dates of onset of the disease between August 16 and October 15, with the three new cases occurring between September 20 and October 15. The 21 cases of this outbreak represent 7.6% of the total of 275 cases reported to date. in San Diego County.

The cases all involve homeless people who resided in multiple locations in downtown San Diego. No source of the epidemic has yet 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 sick people to treatment and housing.

The other steps include:

  • Relocation of currently deployed handwashing stations to areas frequented by homeless people and assessment of the need for additional stations.
  • Increased cleaning of portable and fixed public toilets.
  • Increased sidewalk disinfection from twice a week to seven days a week at this time. The frequency will be evaluated continuously.
  • Notification by the county’s Department of Environmental Health and Quality of the outbreak – and precautions – to downtown food establishments, food charity operators, California Restaurant Association, Downtown San Diego Partnership, to the Homeless and Gaslamp Quarter Association Regional Working Group.
  • Public health nurses conducting outreach activities in shelters.
  • Homeless awareness teams distributing information about Shigella as part of hygiene kits given to homeless people, including 600 more during the week of October 18.

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

Typical symptoms include diarrhea (sometimes bloody), fever, and stomach cramps. While most people will make a full recovery without antibiotic treatment, some people with weakened immune systems can develop a life-threatening illness and may require additional treatment. People with shigella-like symptoms should contact their healthcare provider. The provider may order stool tests to help with the diagnosis.

Strategies for avoiding catching or spreading shigella include frequent hand washing and not preparing food for diarrhea.

More information about Shigella and the precautions are available through the county, a California Health Alert Network Notification and the Centers for Disaster Control and Prevention.

This press release was produced by the San Diego County Government. The opinions expressed here are those of the author.

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