As a fan of the classic text-based computer game “Oregon Trail” who still plays the online version regularly, I never thought I’d read about dysentery making a comeback in the 21st century, but here we are. 

Unironically, cases of dysentery are rising in the Portland, Oregon, metro area.

 KOIN reports: 

Also known as shigellosis, dysentery is a highly contagious bacterial disease that can cause fever, cramps, vomiting and diarrhea. It is spread very easily from person to person when someone gets fecal matter from an infected person into their mouth, health officials say.

According to the health department, two types of Shigella typically circulate in Oregon. Although both strains can cause severe diarrhea, officials are not seeing the strain which can cause more severe or fatal illness. However, they note the strains circulating in Multnomah County are resistant to several antibiotics.

KOIN notes that dysentery cases have been on the rise in Multnomah County since 2012, but “data on dysentery cases collected by the county from 2017-2024 shows a marked increase in the number of cases between 2023 and 2024. Further, January 2025 showed 40 cases reported.” 

The majority of dysentery cases (91%) were caused by person-to-person spread, with fecal-oral spread through intimate contact accounting for between half and more than two-thirds of all reported cases.

More from KOIN:

But of the most recent cluster of cases, the county said 56% were among people experiencing homelessness and 55% of the cases reported methamphetamine or opiate usage. They have also also identified a spread among housed and unhoused social groups who use drugs.

To mitigate the spread of dysentery mong the unhoused population, Multnomah County is providing short-term housing to those who test positive for it, as “greater access to hygiene and sanitation can contribute to reducing the spread of Shigella and other diseases.”

Dr. Amanda Risser, a senior medical director for Central City Concern, a Portland-based health care and housing services provider, and Dr. John Townes, medical director for infection prevention and control at Oregon Health & Science University, told The Oregonian that increased access to public restrooms and handwashing stations could also play a role in lowering the risk of the spread of Shigella. 

“Any situation where (you are) unable to wash your hands regularly will put you at risk for shigella and I think unsheltered homelessness certainly contributes to people just really not having places to do that,” Dr. Risser said. 

Townes echoed that, saying, “If you want to stop an outbreak of shigella, you give people toilets and soap and water, and you train them in how to wash their hands.”

From The Oregonian/Oregon Live:

Close to 6,000 people are living outside in Multnomah County, according to the most recent county estimates obtained by The Oregonian/OregonLive. But there are only about 116 publicly maintained restrooms in Portland, according to a count by The Oregonian/OregonLive. That includes park bathrooms that are locked in winter and library bathrooms that are closed at night.

While housing and a private bathroom for everyone would be ideal, Risser said having a receptacle for infected stool alongside a sink stocked with hand soap in a public restroom is far better than the alternative: Defecating on the sidewalk. In that situation, the sick person has no place to wash their hands, which makes it easy to spread germs to others, and the infected stool is left on the street, allowing the hardy bacteria to hitch a ride on shoe soles. Unfortunately, she said, the sidewalk-as-toilet situation is a phenomenon she’s seen a lot recently.

This is happening at a time when the Trump administration seeks to gut The Office of Community Planning and Development, which funds housing and other support for the unhoused across the nation, and we find ourselves with a Health and Human Services agency that is being led by an anti-vaxxer who is the clear antithesis of health and human service. 

As noted by NPR:

The Community Planning and Development office at HUD disburses more than $3.6 billion in federal funding for rental assistance, mental health and substance use treatment, and outreach to try and get those living outside into shelter or housing. It’s the “backbone” of local communities’ response to homelessness, Oliva said, “in blue states and red states alike.”

Cutting so much staff would mean firing not only people at headquarters in Washington, D.C., but also those in field offices around the country, she said. And that means it would likely take longer to get funding to the thousands of local nonprofits who provide housing and other support.

“Grants need to be processed,” said one HUD employee, speaking on condition of anonymity for fear of retaliation. They said the prospect of major staff cuts, combined with deferred resignations, are a “huge worry” that threatens to disrupt work.

A dysentery epidemic that disproportionately affects the unhoused is easily overlooked by a presidential administration that only cares about rich white men. 

It’s worth noting that Black Americans represent only 13% of the U.S. population but account for 36.6% of the homeless population and more than 37% of homeless families with children, according to the National Alliance to End Homelessness. 

We already know they don’t care about us. 

Black adults “are one of the three fastest-growing homeless populations in Portland, and people of color represent 39% of Portland’s current homeless population,” according to Impact NW. 

These are real problems that require real solutions, and those solutions are in jeopardy as long as this administration continues to get rid of everything that matters. 

“You have died of dysentery” should not be the epitaph of anyone in the 21st century.