Homeless tents downtown 2
Homeless tents on set up on 16th Street in downtown San Diego. Photo by Chris Stone

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

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

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

The county is working with San Diego to identify potential exposure sites, promote good hygienic precautions among homeless service providers and food providers, identify additional cases and connect ill individuals to treatment and housing.

Other steps include:

  • installation of handwashing stations
  • increased cleaning of public bathrooms
  • sidewalk sanitization
  • 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 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 this week

Shigella is a contagious infection typically spread by contaminated surfaces, food or water, or person-to-person. According to the county, those at increased risk include young children, 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 number since 1995.

Typical symptoms include diarrhea — sometimes bloody– as well as fever and stomach cramps. While most people will recover fully without antibiotic treatment, some individuals with poor immune systems can develop life-threatening diseases and might 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.

City News Service contributed to this article.