Island Health is reporting an outbreak of a highly contagious intestinal illness in the South Island’s unhoused community.
Shigellosis is an infection caused by Shigella bacteria. It’s an intestinal illness that spreads from an infected persons feces, through contaminated food, water, surfaces, or person to person.
The shigella bacteria can be stopped by simple hand washing, but with limited access to washrooms or toilets, a cluster of cases is growing within the homeless community.
Island Health is reporting five probable cases on the South Island right now, noting however, it’s likely an undercount.
“More test results and investigations are underway and not all illnesses are reported to health care providers,” the health authority said to CHEK News in a statement.
Shigella causes fever, diarrhea that may contain blood and/or mucous, stomach cramps, nausea and vomiting, and an urge to pass stool.
“Our mobile mission Victoria outreach team has actually seen in recent days, folks that are very ill in various encampments on the lower Island,” said Nicole Mucci, spokesperson for the Union Gospel Mission.
“What they’re seeing is those that are quite ill and don’t have access to healthcare are coming in to municipalities that have more services.”
Island Health is already investigating to see if these cases are connected to a September outbreak in the Cowichan Valley.
Outbreaks reported beyond Vancouver Island
Outside of Island Health’s catchment area, there have been outbreaks in B.C., and in other provinces.
Mucci, experienced a similar outbreak four years ago on Vancouver’s Downtown East Side (DTES).
“It can be actually deadly and very dangerous,” said Mucci. “The sickness just spread really really quickly.”
In January this year there was an outbreak in Toronto.
In Edmonton, there’s been an outbreak of shigella on and off for years. Alberta Health Services says it has identified 447 people with Shigella since August 2022 — 309 of whom were hospitalized.
Bacteria, becoming antibiotic resistant
In healthy people, symptoms can resolve after a week, most, without medical intervention. But for those with more serious cases that need antibiotics doctors warn there’s bad news: the stomach bug is getting more resistant to pills.
Drug-resistant shigella has been reported extensively in Europe, Australia and the United States.
“There’s been cases of it in Seattle and we’ll occasionally see it in Vancouver, but luckily it’s not that well established,” Dr. Aleksandra Stefanovic, a clinical professor at the University of British Columbia and a lead author of a study looking into Shigella infections in the city between 2015 and 2022, told CBC in January.
The city’s response
The City of Victoria spent last week in court arguing it’s not responsible for providing washrooms to unhoused people.
When asked if the outbreak changes anything, city officials differed to Island Health.
“The city would rely on Island Health in terms of any escalated measures,” said Colleen Mycroft, city spokesperson.
Island Health didn’t confirm anything definitive other that it’s “working with the City and partners to strengthen long-term sanitation and hygiene measures that promote health and prevent future illness.”
Mucci says both institutions know that to prevent future outbreaks, homeless people should have access to hygiene and sanitation services like public washrooms and washing sinks.
“When you see an outbreak of shigella it’s really a symptom of broader systemic issues,” said Mucci.
