The County of San Diego has announced two new shigella cases associated with an ongoing outbreak, bringing the total to 26 confirmed and three probable cases among people experiencing homelessness.

The continuing investigation shows onset of illness dates between Aug. 16 and Oct. 21, with the three new cases occurring between Oct. 18 and Oct. 21. The 29 cases in this outbreak represent 9% of the 295 total cases reported to date in San Diego County.

The cases are all among individuals experiencing homelessness with the majority at multiple locations in central San Diego. Three cases outside the City of San Diego are now under investigation. 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 32 currently deployed handwashing stations to areas frequented by homeless individuals.
  • Placement of 15 new handwashing stations. Evaluation of additional need is ongoing.
  • Increased cleaning of portable and fixed public bathrooms.
  • Evaluating potential placements of new portable restrooms.
  • 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, Mission Valley and Hillcrest areas, charitable feeding operators, the California Restaurant Association, Downtown San Diego Partnership,  Regional Task Force on the Homeless and Gaslamp Quarter Association.
  • Public health nurses conducting outreach at shelters.
  • Homeless Outreach Teams offering shelter resources and distributing shigella information as part of hygiene kits given to persons experiencing homelessness, including an extra 600 the week of Oct. 18.
  • The County is assembling an additional 1,000 hygiene kits to distribute to people experiencing homelessness outside of central San Diego.

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.