Dysentery Cases Surge in Portland Metro Area, Linked to Housing and Drug Use
Public health officials in Multnomah County have reported a sharp increase in dysentery cases, also known as shigellosis, across the Portland metropolitan region. Recent data highlights a concerning upward trend, with 40 cases recorded in January 2025 alone—a significant jump compared to previous years.
About Shigellosis
Shigellosis is an infectious disease caused by the Shigella bacteria. It primarily affects the intestines and leads to symptoms such as:
- Severe diarrhea (often bloody or mucous-filled)
- Fever
- Abdominal cramps
- Nausea or vomiting
The bacteria spreads through the fecal-oral route, meaning even microscopic amounts of fecal matter from an infected person can transmit the disease. Common pathways include:
- Person-to-person contact (e.g., inadequate handwashing, intimate contact, or caregiving).
- Contaminated food or water.
- Surfaces or objects contaminated with the bacteria.
Health officials note that Shigella is highly contagious—as few as 10 bacterial cells can cause infection. While most cases resolve within 5–7 days, severe dehydration or complications can arise, particularly in vulnerable groups like young children, older adults, or immunocompromised individuals.
Antibiotic Resistance
The strains circulating in Multnomah County are resistant to multiple antibiotics, complicating treatment. Though officials confirmed the current subtypes are not linked to the most severe or fatal outcomes, resistance underscores the need for cautious antibiotic use and alternative care strategies.
Rising Cases and Vulnerable Populations
Cases of Shigella have been steadily climbing since 2012, with a notable spike between 2023 and 2024. Analysis of cases from 2017 to 2024 revealed that 91% resulted from person-to-person transmission, frequently linked to intimate contact or inadequate hygiene. Recent clusters show:
- 56% of infections occurring among unhoused individuals.
- 55% of cases involved people who reported methamphetamine or opioid use.
Transmission is occurring within both housed and unhoused social networks, particularly among drug users. Health officials attribute the spread to factors like limited access to sanitation, crowded living conditions, and challenges in maintaining hygiene among unhoused populations.
Public Health Response
To curb the outbreak, Multnomah County is offering short-term housing to infected individuals, aiming to improve access to sanitation and reduce transmission. “Housing is inextricably tied to health outcomes,” stated the Health Department. “Lack of stable housing heightens the risk of infectious diseases by limiting opportunities for hygiene and timely medical care.”
Officials stress that expanding public health resources—including hygiene stations, outreach to high-risk groups, and disease monitoring—is critical for containment. They also urge healthcare providers to test for Shigella in patients with severe diarrhea and to report cases promptly.
Prevention and Community Action
Health experts recommend the following to prevent shigellosis:
- Frequent handwashing with soap and water, especially after using the bathroom, changing diapers, or before eating.
- Avoiding close contact with infected individuals until symptoms resolve.
- Ensuring food and water are safe and uncontaminated.
- Encouraging access to hygiene facilities for unhoused populations.
Broader Implications
The rise in shigellosis underscores systemic challenges, including homelessness, substance use, and gaps in sanitation infrastructure. Health authorities emphasize that addressing these root causes—alongside bolstering public health funding—is essential to prevent future outbreaks.
