Bacterial Infection Spreading Throughout Portland Sparks Questions

The Portland, Oregon, metro area is experiencing an influx of cases involving a highly contagious bacterial infection.

Shigella, described by the U.S. Centers for Disease Control and Prevention (CDC) as a "diarrhea germ," is hitting the counties of Multnomah, Washington and Clackamas hard at year's end. The bacteria, which causes about 450,000 infections nationally leading to about $93 million in direct medical costs, is spread in a variety of ways—from transferring bacteria from hands to mouth after touching objects, to a transfer from fecal matter through male sexual intercourse.

Symptoms include bloody or prolonged diarrhea that can last more than three days, fevers, stomach pains and feeling an urge to pass a stool when the bowels are empty.

"While we are currently seeing an increase in Shigella cases in the Portland metro area, the risk to the broader public remains low at this time and there are no measures for most folks to take at this time," Multnomah County Deputy Health Officer Teresa Everson said in a statement shared with Newsweek. "The best thing we can all do to prevent both respiratory viral illness and diarrheal illness is to keep practicing good hand hygiene."

While previously studied and evaluated in the tri-county area dating to 2012, there have been 218 known cases reported in the metro area this year, including 45 in December alone. Between September and the end of November, there were 16 cases reported in Multnomah County.

Shigella case counts in the tri-county area totaled 98 in 2021, and 150 in 2022.

"Current disease patterns in Multnomah County suggest that fecal-oral spread through sexual contact may account for between half and more than two-thirds of all cases without international travel," Sarah Dean, a spokesperson from Multnomah County, told Newsweek via email.

Everson said same-sex male partners and those who are homeless are most at risk.

"These cases can occur because bathrooms, handwashing sinks and soap can be hard to access when you aren't housed," Everson said, according to local media outlets. "And unhoused community members are at higher risk of infectious diseases in general, as they experience poorer health than the broader public."

But people not in those particularly vulnerable populations should not be alarmed, Everson added.

"We have not seen cases of folks in the general public who have acquired infection that we can't explain," she said. "Most of the cases that we are seeing are associated with sexual activity, and some with travel. So, we do not have any cases that would point us to a risk to the general public."

Shigella strains in the Portland metro area since 2017 have shown high proportions of resistance to antibiotics, she added, and in situations where antibiotics are needed, area clinicians have been encouraged to do testing to determine which antibiotics will be effective before starting treatment whenever possible.

Sara McCall, a communicable disease program manager in Multnomah County, said that the most effective intervention is to provide motel vouchers for people who have contracted Shigella.

"It gets them off the streets at the time when they are potentially most infectious, so they aren't visiting shelters or potentially spreading it to other people," McCall told Oregon Public Broadcasting. "It also gives them ready access to hygiene and toileting so they can take care of themselves."

Blair Best, a journalist for local NBC news affiliate KGW, said that one person found out he had Shigella after checking himself into a detox facility. He spent five days in a hospital.

"I couldn't hold any food down," Michael Moreland Jr. said. "It's gross, but I soiled my clothes. It's disgusting."

Bobby Artale, another local, told ABC affiliate KATU that he suffered from Shigella for two weeks and had "uncontrollable diarrhea."

While no clear geographic pattern exists for why this case uptick has occurred, some surmise that cases have escalated because of the homeless population in downtown Portland's Old Town neighborhood.

"We were forewarned in advance by some folks at the city," Jessie Burke, one of the co-owners of the Society Hotel in Old Town, told KGW.

She hopes residents still frequent the neighborhood and don't view it as a major issue.

Update 12/29/23, 11:27 a.m. ET: This story was updated with comment from Multnomah County.