Shigella - Shigellosis

Situation

There is a current Shigella outbreak (Shigellosis) among persons experiencing homelessness (PEH) in San Diego County that was first identified October 7, 2021. For updates on the Shigella outbreak, visit the County News Center

 

Outbreak Summary Update

Epidemiology

In total, there are 48 outbreak-related cases (41 confirmed, 7 probable). All cases are experiencing homelessness. There have been no deaths. Ages range from 19 – 70 years. Exposure periods range from August 11th to November 20th. The most recent symptom onset date is November 21st. Forty-one (41) cases report substance use, 37 are known to use methamphetamine.

Descriptive Characteristics of Shigella Outbreak Cases (N=48)
Updated November 30, 2021

Characteristics Total (N=48)
  Freq (%)
Gender
Male 28 (58.3)
Female 18 (37.5)
Transgender Female 2 (4.2)
Age Group  
<18 0 (0)
18-44 22 (45.8)
45-64 22 (45.8)
≥65 4 (8.4)
Race and Ethnicity  
American Indian/ Alaskan Native 0 (0)
Asian 0 (0)
Black, non-Hispanic/Latino 12 (25)
Hispanic/Latino 11 (23)
Native Hawaiian/Pacific Islander 0 (0)
White, non-Hispanic/Latino 24 (50)
Other 1 (2)
Hospitalizations 33 (68.8)
Sexual Orientation  
Heterosexual 19 (39.6)
MSM 2 (4.2)
Decline to Answer  2 (4.2)
Unknown  22 (52)
Substance Use  
Yes 41 (85.4)
No 2 (4.2)
Unknown 5 (10.4)

Figure 1. Epidemiological curve

Shigellosis Cases graph

Note: Website is updated weekly.

 

Important Information

Shigella (shih-GEHL-uh) is a bacterium that causes a disease called shigellosis. Children younger than 5 years are most likely to get shigellosis, but people from all age groups can get this disease. Most people with shigellosis will get better within 5 to 7 days without medical treatment. However, Shigella bacteria can cause more severe illness in infants, the elderly, or people with immune systems weakened by cancer, cancer treatments, or other serious conditions (like diabetes, kidney failure, liver disease, and HIV/AIDS).

Shigella-CDC

Symptoms

People who come in contact with Shigella usually start experiencing symptoms 1 to 2 days after the contact with the bacteria. Symptoms of shigellosis may include:

  • Diarrhea (sometimes bloody)
  • Fever
  • Stomach pain
  • Feeling the need to pass stool (poop) even when the bowels are empty

Most people with shigellosis will get better within 5 to 7 days without medical treatment. However, Shigella bacteria can cause more severe illness in infants, the elderly, or people with immune systems weakened by cancer, cancer treatments, or other serious conditions (like diabetes, kidney failure, liver disease, and HIV/AIDS).

Transmission

People usually get sick from Shigella bacteria after putting something in their mouth or swallowing something that has come into contact with the stool (poop) of someone else who is sick with shigellosis. Just a small amount of Shigella bacteria can make someone sick.

People can get sick by:

  • Getting Shigella bacteria on their hands, which may happen after:
    • Changing diapers of children who are infected with the germ
    • Touching people who are sick who might have the germ on their hands or bodies
  • Eating food that was prepared by someone who is sick with the germ
  • Swallowing recreational water (for example, lake or river water) while swimming or drink water that was contaminated with stool containing the germ
  • Having exposure to stool during sexual contact with someone who is sick 
     

Prevention

Shigella bacteria can spread very easily from person to person, so the best thing to do to keep from getting sick is to wash your hands with soap and water—especially after using the bathroom, after changing a child’s diapers, and before preparing food and eating.

If soap and water are not available, use an alcohol-based hand sanitizer with at least 60% alcohol (check the product label to be sure). Hand sanitizer with at least 60% alcohol is effective in killing Shigella bacteria. But use soap and water as soon as possible afterwards because hand sanitizer does not kill all types of germs and may not work as well if hands are visibly greasy or dirty.
 

Diagnosis

Many kinds of germs (e.g., bacteria, viruses, parasites) can cause diarrhea. Knowing which germ is causing an illness is important to help guide appropriate treatment. Healthcare providers can order laboratory tests to identify Shigella bacteria in the stool of an infected person.
 

Treatment

People who have shigellosis usually get better without antibiotic treatment in 5 to 7 days. People with mild shigellosis may need only fluids and rest. Bismuth subsalicylate (for example, Pepto-Bismol) may be helpful, but people sick with shigellosis should not use medications that slow down the way our body digests food, such as loperamide (for example, Imodium) or diphenoxylate with atropine (for example, Lomotil).

Healthcare providers may prescribe antibiotics to people with severe cases of shigellosis to help them get better faster. However, some antibiotics are not effective against certain types of Shigella. Healthcare providers can order laboratory tests to determine which antibiotics are likely to work. Tell your healthcare provider if you do not get better within a couple of days after starting antibiotics. They can do more tests to learn whether your type of Shigella bacteria can be treated effectively with the antibiotic you are taking. If not, your doctor may prescribe another antibiotic.

For more information, contact the Epidemiology Unit at (619) 692-8499 or send us an e-mail.