A growing outbreak of Shigella infections, primarily affecting homeless populations in Canadian cities, underscores the urgent need for improved hygiene and sanitation services. The bacterial infection, which causes severe diarrhea, stomach cramps, and fever, has been confirmed in at least 11 cases in Toronto, with similar outbreaks reported in Edmonton and Vancouver. Experts warn the situation is exacerbated by antibiotic resistance, making treatment increasingly difficult.
Toronto night nurse Keren Elumir, working at a Moss Park safe consumption site, has observed a rise in infections over the past five weeks. The spread of Shigella, transmitted through minimal contact with contaminated stool, is preventable through simple hygiene practices such as handwashing and access to clean facilities. However, the lack of public washrooms and showers for homeless individuals has created significant barriers.
Edmonton, which has seen 447 cases since 2022, reduced its outbreak by providing basic sanitation services like showers, laundry facilities, and clean clothing. However, health officials note the challenges of keeping pace with new cases. Vancouver has faced similar outbreaks, with public health experts describing Shigella as a “disease of poverty” that thrives in conditions of poor sanitation and overcrowding.
The infection has become more severe among homeless populations, where malnutrition and substance use disorders weaken immune responses, leading to higher rates of hospitalization. Adding to the crisis, antibiotic resistance has rendered oral treatments ineffective in most Toronto and Vancouver cases, with severe infections requiring IV antibiotics and hospital care.
Public health experts emphasize that prevention is the most effective strategy to control the spread of Shigella. This includes investing in accessible hygiene infrastructure such as public toilets and handwashing facilities for homeless communities. With the emergence of more drug-resistant strains worldwide, including occasional detections in Canada, the need for proactive measures has never been more critical.
Addressing this crisis requires a coordinated effort among various stakeholders to ensure hygiene services are accessible to the most vulnerable, curbing the spread of this debilitating and increasingly difficult-to-treat infection.
