Public-health officials and politicians are using terms like disaster and public-health crisis to describe the outbreaks, and they are warning that these diseases can easily jump beyond the homeless population.
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“Our homeless crisis is increasingly becoming a public-health crisis,” California Governor Gavin Newsom said in his State of the State speech in February, citing outbreaks of hepatitis A in San Diego County, syphilis in Sonoma County, and typhus in Los Angeles County.
“The hygiene situation is just horrendous” for people living on the streets, says Glenn Lopez, a physician with St. John’s Well Child & Family Center, who treats homeless patients in Los Angeles County. “It becomes just like a Third World environment, where their human feces contaminate the areas where they are eating and sleeping.”
Those infectious diseases are not limited to homeless populations, Lopez warns: “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.
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.