The Multnomah County Health Department ordered the immediate closure of the Small Pharaoh #1 food cart in downtown Portland (SW 5th and Stark) late Tuesday, Aug. 11, 2020 after linking the business to an outbreak of shigellosis. This is the first food cart closure in Multnomah County in many years due to health concerns. Food carts are inspected, regulated and scored the same as brick and mortar restaurants.

Shigellosis is caused by a type of bacteria known as shigella that can cause severe gastrointestinal illness in people, including diarrhea, fever and cramps. It can also lead to more severe illnesses such as sepsis and kidney injury. Local data indicate that one out of three diagnosed infections typically require hospitalization.

Shigella is spread through food, through water, or person to person by swallowing fecal matter. Most people recover without treatment, and  this particular strain is highly resistant to the most common antibiotics used to treat shigellosis.

Health officials took the unusual step of ordering the closure of the food cart at 5th and SW Stark after several individuals from different households were confirmed to have shigellosis after eating food from the facility. Four cases have been confirmed with three additional presumptive cases with symptoms who have not been tested. Shigella is a very contagious bacteria and can spread after swallowing a very small amount of the bacteria.

Anyone with symptoms of shigellosis who ate at the downtown location of Small Pharaoh between July 27 and August 11 should contact their care provider or seek medical care as needed.

In general, anyone ill with diarrhea should stay home from work, especially if they prepare food or work in child care or a long-term care facility. Shigella can spread easily among people who live together. To prevent spread in a household: wash hands well before eating and after using the bathroom, and avoid sex until the diarrhea is completely gone.

Health care providers who believe someone is ill enough to need antibiotics should consult with an infectious disease specialist and Multnomah County Health Department about the details of drug resistance.

For consultation or to report possible illness associated with this outbreak, call 503-988-3406.

Shigella is a reportable illness, and 47 cases have been reported to the Health Department in 2020. Historically, the majority of shigella infections in the Portland area are acquired during international travel or through intimate contact among men who have sex with men. Since 2015, Multnomah County has identified cases among persons experiencing homelessness that were caused by shigella strains that had been previously circulating in the area among housed individuals. In other parts of the United States, shigella frequently causes outbreaks in childcare and long-term care facilities