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A severe stomach bug has spread through Montreal’s homeless population, raising concern among shelter workers who say not enough is being done to contain it.
Shigella infection, also known as shigellosis, leads to diarrhea, stomach cramps and fever.
Its spread can be prevented by simple hygiene, such as handwashing, but the bacterial infection is affecting some of the city’s homeless population, who don’t often have access to clean water and washrooms.
One worker at the Old Brewery Mission, one of the city’s largest shelters, said they don’t believe the measures in place at the site are sufficient. They have reported the situation to the province’s workplace safety board.
“Employees are not confident it’s being taken seriously enough,” said the person, whom CBC agreed not to identify out of concern for their job security.
“We don’t feel supported.”
Michelle Patenaude, executive director of CAP Saint-Barnabé, which operates three shelters in eastern Montreal, said her organization has been taking precautions to curb the spread of the bacteria. At one point, Patenaude said she was forced to restrict access to some services.
“We welcome particularly vulnerable people daily, in collective environments where infection prevention is a major challenge,” she said in an email. “Nobody is taking this situation lightly.”
Julien Montreuil, head of L’Anonyme, a group that works with people in encampments, said he believes the situation is under control for now. But he said that, for people who live in tents, even the basic hygiene advice from public health officials “can sometimes be complicated.”
Advisory sent to medical staff
The problem was first flagged by health authorities in September, and then again in October.
Santé Québec, the Crown corporation responsible for the province’s health network, circulated an advisory on Oct. 26 to front-line medical staff and specialists, obtained by CBC News, warning about a rise in multidrug-resistant infections of shigella among the city’s homeless population that began in September in the east end.
The advisory said the “highly contagious nature of the infection,” as well as “crowded conditions in shelters” and “limited access to sanitary facilities” could all contribute to transmission.
It also stressed the need to rapidly report cases in order to trace the spread.
In an email, Montreal Public Health said 45 shigellosis cases have been confirmed among the city’s homeless population since late August. The city typically records about 150 cases annually across the entire population.
Spokesperson Geneviève Paradis said the agency has deployed staff to affected shelters to reinforce hygiene protocols. But Paradis said it is “crucial that none of these measures restrict access to the care, services and resources people need.”
William Hodgson, a spokesperson for the Old Brewery Mission, said the shelter takes the situation “very seriously,” and has been working with public health authorities.
“If communications weren’t good enough, we want to be better at that,” he said.
WATCH | Montreal aims to address growing encampments:
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Growing cases in Canadian cities
Shigellosis, one of the main causes of dysentery, spreads from person to person through an infected person’s stool.
A microscopic amount of the bacteria on surfaces, in food or water can be enough to get someone sick. The bacteria also remains contagious for weeks after episodes of intense diarrhea.
The bacterial infection has become more common among homeless people in North American cities, including Vancouver, Edmonton and Toronto, and research indicates it is also increasingly resistant to antibiotics.
A recent study by researchers at the University of British Columbia found cases were on the rise among homeless people in Vancouver. The authors warned that greater outreach was necessary to crack down on the bacterial infection.
Dr. Carl Boodman, an expert in infectious diseases at the McGill University Health Centre, told CBC the bacterial infection is treatable and preventable.
He said outbreaks are linked, ultimately, to a lack of adequate housing and a lack of access to “public sanitation infrastructure for those who are experiencing homelessness.”
WATCH | Why this stomach bug is getting harder to treat:
Stomach bug circulating among homeless population getting harder to treat
Toronto Public Health has reported at least 11 confirmed cases of Shigella infection, all among homeless people. The bacterial infection causes diarrhea, can be spread by as few as 10 bacteria and is becoming increasingly resistant to antibiotics.