Close, But No Cigar
The initial outbreak was declared to be at its end in February of 2023, but less than a month later it was reinstated. To date, AHS has identified 281 people who’ve contracted Shigella. More alarming than that number is that 194 of those people required hospitalization.
No one has yet died from the illness, but it is remarkable that nearly 65 per cent of those infected required hospital care, according to Lynora Saxinger.
“That number is shockingly high,” says Saxinger, an infectious disease expert with the University of Alberta.
Shigella most typically occurs when a person ingests food, water or other material tainted with Shigella infected feces. It’s strikingly contagious, sometimes requiring exposure to as little as 10 organisms. That’s in contrast to something like salmonella, which can require exposure of up to 1,000 or more organisms for illness to take hold, according to Health Canada.
But the illness is relatively rare in developed nations like Canada, where it’s most traditionally found in those who have been travelling abroad to areas with lower sanitation standards and occasionally among men who have sex with men. In recent years, it’s been showing up more and more in unhoused populations.
With a rate of hospitalization that high, Saxinger says the outbreak is likely much more widespread than we realize.
“It probably means we’re missing a whole bunch of other cases that are less severe,” she says.
While outbreaks of this size and severity are rare in Canada, they’re not unheard of and most often it is marginalized, immunocompromised and vulnerable populations — much like those living in encampments in our inner-city — who are most impacted.
In 2021, Vancouver’s downtown east side community — home to the infamous East Hastings strip — experienced its own Shigella outbreak. While exact figures as to the caseload experienced in Vancouver are not readily available, various reporting from the time pegs the number between 10 and 24 cases.