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. 2018 Mar;76(3):280-285.
doi: 10.1016/j.jinf.2017.11.010. Epub 2017 Dec 5.

Heavy precipitation as a risk factor for shigellosis among homeless persons during an outbreak - Oregon, 2015-2016

Jonas Z Hines  1 , Meredith A Jagger  2 , Thomas L Jeanne  3 , Nicole West  3 , Andrea Winquist  4 , Byron F Robinson  4 , Richard F Leman  2 , Katrina Hedberg  2
Affiliations

Heavy precipitation as a risk factor for shigellosis among homeless persons during an outbreak - Oregon, 2015-2016

Jonas Z Hines et al. J Infect. 2018 Mar.

Abstract

Objectives: Shigella species are the third most common cause of bacterial gastroenteritis in the United States. During a Shigella sonnei outbreak in Oregon from July 2015 through June 2016, Shigella cases spread among homeless persons with onset of the wettest rainy season on record.

Methods: We conducted time series analyses using Poisson regression to determine if a temporal association between precipitation and shigellosis incidence existed. Models were stratified by housing status.

Results: Among 105 infections identified, 45 (43%) occurred in homeless persons. With increasing precipitation, cases increased among homeless persons (relative risk [RR] = 1.36 per inch of precipitation during the exposure period; 95% confidence interval [CI] = 1.17-1.59), but not among housed persons (RR = 1.04; 95% CI 0.86-1.25).

Conclusions: Heavy precipitation likely contributed to shigellosis transmission among homeless persons during this outbreak. When heavy precipitation is forecast, organizations working with homeless persons could consider taking proactive measures to mitigate spread of enteric infections.

Keywords: Climate change; Disease outbreaks; Homeless persons; Rain, adverse effects; Shigella sonnei.

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Conflict of interest statement

Conflict of interest

The authors have no conflicts of interest to declare.

Figures

Fig. 1.
Fig. 1.
a. Cases of Shigella sonnei infections among homeless persons with overlay of precipitation during an outbreak – Oregon, July 2015–June 2016. b. Cases of Shigella sonnei infections among housed persons with overlay of precipitation during an outbreak – Oregon, July 2015–June 2016. Precipitation and Shigella cases are shown during the week in which they occurred. In the time series analysis, the daily shigellosis case count was regressed on the 1-week lagged cumulative weekly precipitation to account for the time for precipitation-related behavioral and environmental changes that might increase risk of contact with Shigella-contaminated matter that may occur and the effect of multiple days of accumulated precipitation.
See this image and copyright information in PMC

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