HomeMy WebLinkAboutshigella-advisory-for-homeless-health-care-and-services-providers-2-16-2024ALAMEDA COUNTY HEALTH CARE FOR THE HOMELESS
1404 Franklin Street, Suite 200
Oakland, CA 94612
TEL (510) 891-8950
FAX (510) 832-2139
www.achch.org
February 16, 2024
Shigella Advisory:
Homeless Outreach, Shelter, Harm Reduction Provider and
Administrators
The Alameda County Health Care for the Homeless program is responding to reports of Shigella
infections in Alameda County. These cases have been reported in persons experiencing
homelessness, among people who use drugs and among residents of board & care facilities.
Key messages for services providers:
• Frequent, thorough hand-washing by all, especially after bathroom and before eating
• Anyone with diarrhea should not perform any duties that involve cooking, handling of food
contact surfaces or utensils, and working in the food preparation and food service
• Anyone with diarrhea should be directed to medical care promptly, and ask to be tested
for Shigella as well as other common causes of diarrheal illness
What is Shigella
Shigellosis (Shigella) is a diarrheal infection caused by Shigella bacteria, most commonly S. sonnei
and S. flexneri. Shigella is extremely contagious – it is easily transmitted through person-to-person
contact (poop-hands-mouth) and through contaminated food, water and other routes. Most
Shigella infections are mild and treatable with antibiotics, but Shigella can be very serious and fast
spreading, so it is critical to identify, prevent and control cases of this diarrheal disease.
How to Recognize Possible Cases
People with Shigella infection usually start experiencing symptoms 1 to 2 days after contact with the
germ. Shigella symptoms include:
• Diarrhea that can be bloody or prolonged (lasting more than 3 days)
• Fever
• Stomach pain
• Feeling the need to pass stool (poop) even when the bowels are empty
Some people will not have any symptoms. Symptoms usually last 5 to 7 days.
How to Respond to Possible Cases
People with diarrhea should be urged to contact a doctor (primary care or Emergency Department)
if they have any of these symptoms:
• Fever
• Bloody or prolonged diarrhea
• Severe stomach cramping or tenderness
• Dehydration
Shigella is a reportable disease, and the public health department works quickly to respond to
reported cases. Please reach out to ACHCH with any concerns or questions. Suspected outbreak of
diarrhea is reportable to public health and requires quick response to prevent spread of infection.
Please contact ACHCH and ACPHD to report suspected outbreaks.
Diagnosis & Treatment
Diagnosis:
• Shigella is diagnosed through laboratory analysis of stool (poop) of an ill person. In a clinic, a
patient with Shigella symptoms should receive lab blood, stool and susceptibility testing for
diagnosis and treatment.
Treatment:
• Treatment includes oral antibiotics, which need to be taken exactly as directed. People who
have shigellosis usually get better without antibiotic treatment in 5 to 7 days.
• Antibiotics can shorten the time you have fever and diarrhea by about 2 days. Ciprofloxacin
and azithromycin are two recommended oral antibiotics.
• People with Shigella should drink plenty of fluids to prevent dehydration.
• Tell your healthcare provider if you have other medical conditions or a weakened immune
system—for example, because of an HIV infection or chemotherapy treatment. If you have a
weakened immune system, you may be more likely to become severely ill.
How to Report Cases/Outbreaks
Report suspected or confirmed cases of Shigella to Alameda County Public Health Department,
especially if the case is known to reside or work in a congregate setting or is experiencing
homelessness:
• Report by phone during business hours M-F 8:30-5PM at 510-267-3250 Option 2
• fax: 510-273-3744 or via secure email to AcuteCD@acgov.org.
Prevention & Universal Precautions
Staff of homeless shelter, outreach, food or services programs should carefully review their infection
control procedures and be careful of the following:
• Food or drink that is prepared or handled by someone infected with Shigella can make other
people sick.
• Food or services staff should tell managers when they are sick, stay home until diarrhea
ends, and at work, wash hands frequently.
To mitigate risk of infection:
• Wash your hands with soap and water during key times:
o Before preparing food and eating.
o After changing a diaper or helping to clean another person who has defecated
(pooped).
• Increase availability of handwashing sinks in homeless shelters and encampments or other
locations where people experiencing homelessness spend time
• Increase accessibility of public restrooms in communities with large numbers of people
experiencing homelessness
• Ensure that public restrooms and portable sanitation services are clean and well-maintained
• Distribute educational resources about personal and sexual hygiene in homeless sites or
shelters
• Provide communication and preparedness resources promoting handwashing behavior
change, food safety, and safe water practices
• Homeless services staff should make flyers and information available to staff and clients.
• Shelter, food, and services providers should review infection control processes
Resources and More Information:
• Do You Have Diarrhea?
• Fact sheets
• Handwashing Posters
• Information for food service workers and managers
• ACHCH Communicable disease webpage
• Frequently asked questions
• ACHCH Regional Coordinators: Homeless service providers can reach out to the following
ACHCH Regional Coordinators as needed for consultation, questions, and issues related to
concerns about communicable diseases such as Shigella among people experiencing
homelessness:
o North County (Albany, Berkeley, Emeryville): Andrea Zeppa; Phone: (510) 912-8610;
Email: Andrea.Zeppa@acgov.org
o Oakland: Lynette Ward; Phone: (510) 504-1298; Email: Lynette.Ward@acgov.org
o Mid County (Alameda, Hayward, San Leandro, Union City, Unincorporated): Phil
Clark; Phone: (510) 504-1294; Email: Phil.Clark@acgov.org
o South & East County (Fremont, Newark, Livermore, Dublin, Pleasanton,) Hanna Toda;
Phone: (510) 891-8943; Email: Hanna.Toda@acgov.org