MONTREAL — Montreal Public Health has confirmed 45 cases of a severe stomach infection among the city's homeless population since late August. The bacterial infection, shigellosis, causes diarrhea, stomach cramps and fever. Its spread can be prevented by hygiene like handwashing, but shelter workers say many people lack access to clean water and washrooms. A worker at the Old Brewery Mission said they do not believe the shelter's current measures are sufficient and have reported the situation to the province's workplace safety board.
"Employees are not confident it's being taken seriously enough," said the person, who was not named due to job security concerns. William Hodgson, a spokesperson for the Old Brewery Mission, said the shelter takes the situation "very seriously" and is working with public health. "If communications weren't good enough, we want to be better at that," Hodgson said. Provincial health authorities first flagged the problem in September and issued an advisory on Oct. 26 about a rise in multidrug-resistant shigella infections.
The advisory warned that the "highly contagious nature of the infection," along with "crowded conditions in shelters" and "limited access to sanitary facilities" could fuel transmission. It stressed the need for rapid case reporting to trace the spread. Geneviève Paradis, a spokesperson for Montreal Public Health, said the agency has sent staff to shelters to reinforce hygiene protocols. Paradis said it is "crucial that none of these measures restrict access to the care, services and resources people need."
Michelle Patenaude, executive director of CAP Saint-Barnabé, said her organization has taken precautions and at one point restricted access to some services. "We welcome particularly vulnerable people daily, in collective environments where infection prevention is a major challenge," Patenaude said in an email. "Nobody is taking this situation lightly." Julien Montreuil, who leads a group working with people in encampments, said he believes the situation is under control for now.
Montreuil said that for people living in tents, following basic hygiene advice from public health "can sometimes be complicated." Shigellosis spreads through contact with an infected person's stool, and a microscopic amount of the bacteria can cause illness. The infection remains contagious for weeks after diarrhea subsides. The city typically records about 150 shigellosis cases annually across its entire population.
The bacterial infection has grown more common among homeless populations in cities like Vancouver, Edmonton and Toronto, and research shows increasing antibiotic resistance. A recent University of British Columbia study found rising cases among homeless people in Vancouver and called for greater outreach. Dr. Carl Boodman, an infectious disease expert at the McGill University Health Centre, said the infection is treatable and preventable. Boodman said outbreaks are ultimately linked to inadequate housing and a lack of access to "public sanitation infrastructure for those who are experiencing homelessness."