More than 100 people, mostly homeless, have contracted shigellosis, a bacterial gastrointestinal infection, in the Seattle region since October 2020, The Seattle Times reported May 19.
A lack of sanitation resources has likely fueled the outbreak, experts say. The pandemic has caused places like libraries and restaurants to close their bathrooms to the public, compounding access issues for people experiencing homelessness and living outdoors who typically rely on them to use the bathroom or get clean drinking water.
"I think that's definitely contributing to an outbreak, particularly of this size," Elysia Gonzalez, BSN, medical epidemiologist with Public Health — Seattle & King County, told the news outlet. "It may not have been the original reason, but it is likely exacerbating it."
Eighty-four percent of the reported infections occurred among those experiencing homelessness. While the typical hospitalization rate for the disease is between 20 percent and 30 percent, 62 percent of those infected during this outbreak have required hospitalization, often with severe symptoms such as dehydration, according to the report.
The higher hospitalization tied to this outbreak is likely due to compromised immune systems and underlying malnutrition, experts told The Seattle Times.
In addition to shigellosis, public health officials have also seen a rise in E. coli and cryptosporidiosis, among the region's homeless population. All three infections are spread through fecal-oral transmission.
Public health advocates are now asking the city to reopen downtown drinking water fountains. Lawmakers are also urging the city to install "street sinks," or hand-washing stations throughout the area.
"In the context of diminishing [COVID-19] case counts, in the context of vaccines rolling out and wanting to prevent additional spread of these illnesses and making sure people have access to clean drinking water, it's an appropriate thing to bring back," TJ Cosgrove, community health-services division director at Public Health, told the news outlet.
The source of the shigella outbreak has not been identified, though public health officials point to a drop in new infections in March as a sign the outbreak will soon end.