Typhus, tuberculosis, and other illnesses are spreading quickly through camps and shelters.
Jennifer Millar stays in a homeless encampment off a Hollywood freeway ramp. She is constantly cleaning the concrete sidewalk around her, and is extremely careful when si manages the trash because she has to worry about all of the piles of trash and human feces that don’t offer quite the most sanitary conditions. She keeps trash bags and hand sanitizer near her tent, and she regularly pours water mixed with hydrogen peroxide on the sidewalk nearby. Keeping herself and the patch of concrete she calls home clean is a top priority.
Infectious diseases — some that ravaged populations in the Middle Ages — are resurging in California and around the country, and are hitting homeless populations especially hard.
Los Angeles recently had a typhus outbreak in downtown and around City Hall. With the spreading of the disease through fleas, rats, and the homeless, many say that medieval diseases are going to make a comeback in California. In the past two years, California has also seen an increase in Hepatitis A cases. Usually spread through feces in the homeless community, the disease has recently infected more than 1.000 people in the southern part of the state.
“Our homeless crisis is increasingly becoming a public-health crisis,” Gov. Gavin Newsom said in his State of the State speech in February.
Washington State isn’t safer either when it comes to infectious diseases
People in Washington State have been infected with Shigella bacteria, which is spread through feces and causes the diarrheal disease shigellosis, as well as Bartonella quintana, or trench fever, which spreads through body lice.
Hepatitis A, also spread primarily through feces, infected more than 1.000 people in Southern California in the past two years. The disease also has erupted in New Mexico, Ohio, and Kentucky, primarily among people who are homeless or use drugs.
Public-health officials and politicians are making alarming statements by coming even to use terms such as disaster and public-health crisis to describe the outbreaks, and they are warning that these diseases can easily jump beyond the homeless population.
One of the reasons why these disease have flourished is that the homeless population has grown alarmingly during the past two years.
The diseases have flared as the nation’s homeless population has grown in the past two years: About 553.000 people were homeless at the end of 2018, and nearly one-quarter of homeless people live in California.
The diseases spread quickly and widely among people living outside or in shelters, and is also sustained by human feces contaminated sidewalks, crowded living conditions, weakened immune systems, and limited access to health care.
Basically, the conditions are similar to a Third World environment, where the hygiene situation is just terrible.
And the even worse news is that the homeless population isn’t the only one that’s getting infected. Even someone who believes they are protected from these infections [is] not. At least one Los Angeles city staffer said she contracted typhus in City Hall last fall. And San Diego County officials warned in 2017 that diners at a well-known restaurant were at risk of hepatitis A.
There were 167 cases of typhus from January 1, 2018, through February 1 of this year, up from 125 in 2013 and 13 in 2008, according to the California Public Health Department.
Typhus is a bacterial infection that can cause a high fever, stomach pain, and chills but can be treated with antibiotics. Outbreaks are more common in overcrowded and trash-filled areas that attract rats.
Hepatitis A is caused by a virus usually transmitted when people come in contact with the feces of infected people. Most people recover on their own, but the disease can be very serious for those with underlying liver conditions. There were 948 cases of hepatitis A in 2017 and 178 in 2018 and 2019, the state public-health department said. Twenty-one people have died as a result of the 2017–18 outbreak.
This all represents a public health disaster that need to be attended to as quickly as possible.
New York City is not seeing any infectious disease outbreaks
New York City, where the majority of the homeless population lives in shelters rather than on the streets, has not experienced the same outbreaks of hepatitis A and typhus, says Kelly Doran, an emergency-medicine physician and assistant professor at New York University. But Doran says different infections occur in shelters, including tuberculosis, a disease that spreads through the air and typically infects the lungs.
People living on the streets or in homeless shelters are vulnerable to such outbreaks because their weakened immune systems are worsened by stress, malnutrition, and sleep deprivation. Many also have mental illness and substance-abuse disorders, which can make it harder for them to stay healthy or get health care.
Recently, medical experts have even started walking around with medical supplies in Hollywood and asked if they had any health issues that needed checking. Getting people off the streets inside a clinic is a really big thing because they are extremely distrustful of the health care system.
During the hepatitis-A outbreak, public-health officials administered widespread vaccinations, cleaned the streets with bleach and water, and installed hand-washing stations and bathrooms near high concentrations of homeless people.
But health officials and homeless advocates said more needs to be done, including helping people access medical and behavioral health care and affordable housing.
“It really is unconscionable,” says Bobby Watts, the CEO of the National Health Care for the Homeless Council, a policy and advocacy organization. “These are all preventable diseases.”