Publisher Platform: We need to solve homelessness for many reasons

Public health officials in two California counties are warning of the spread of two public health threats – Shigella and Hepatitis A. Each of these “bugs” – one a bacteria and one a virus – is transmitted through human feces.

For moral reasons, we must ensure that our fellow citizens have access to housing, good food, clean water and bathrooms. We must also recognize the health consequences for those same people, as well as the financial consequences for all of us as a result of inadequate health insurance. We also need to be aware that these “bugs” do not remain in homeless encampments, but can spread to the larger community.

Solving a moral problem can also solve a public health problem.

Here are some recent announcements of an ongoing and nationwide problem.

The Santa Clara County Department of Public Health and its partners continue to respond to an outbreak of Shigella among people experiencing homelessness in Santa Clara County. As of Monday morning, nine people have tested positive for Shigella in connection with this outbreak investigation, six of them have been hospitalized and 21 more presumptive cases have been identified in the province. Public Health is working with the City of San José and other partners to prevent more people from getting sick and to connect those who are sick with care. Public Health continues to provide guidance on the appropriate use of personal protective equipment, restroom sanitation, and safe food practices for partners working in and around camps.

Several encampments are located along the Guadalupe River. Public health workers and community organizations are providing clean water and advising encampment residents not to use river water for drinking, bathing, cooking or toileting.

The risk to the general public remains low. Shigella can spread through water and only a small number of individual organisms are needed to cause disease. Because infected individuals have reported using the river for bathing and toileting, Public Health recommends that everyone use the waters of the Guadalupe River downstream of Route 85 (Highway 85) – the intersection of Highway 85 and Almaden Expressway – avoids. Avoid using the water for recreation, drinking, bathing, cooking and toileting. River water is not potable and may contain a variety of disease-causing organisms. People who come into contact with Guadalupe River water downstream of Highway 85 should avoid swallowing the water and should wash with soap and water before eating or touching their face. Employees of partner organizations who may come into contact with river water in the vicinity of the encampments are advised to wear personal protective equipment.

Shigella is a highly contagious bacteria that can cause diarrhea and sometimes serious illness. It only takes a small amount of contact (10-100 organisms) with Shigella bacteria to make someone sick. That is why it is important to respond quickly when outbreaks occur. Shigella can be spread by eating or drinking food contaminated with the bacteria, or by direct contact with the bacteria from someone with a Shigella infection or from a shared surface. In most healthy people, the infection clears up without treatment.

Public health routinely monitors for cases of Shigella. It is one of many diseases and conditions that must be reported to local health departments.

The Los Angeles County Department of Public Health is investigating an outbreak of hepatitis A infections. Public health has identified five cases among people experiencing homelessness since mid-March 2024. Hepatitis A is a highly contagious liver infection that can be passed from person to person even before they feel sick. The infection is caused by the hepatitis A virus, which is found in the feces and blood of people who are infected. Unhoused individuals are at greater risk of contracting hepatitis A infection as they often have limited access to handwashing and toilet facilities.

Public Health is offering free hepatitis A vaccines to people experiencing homelessness in camps and temporary housing sites where there is a risk of possible exposure. Hepatitis A vaccine is typically a two-dose vaccine series that is safe and highly effective at preventing infections. In addition, previously unvaccinated people can receive a hepatitis A vaccine soon after exposure to protect against developing the infection.

Public Health continues to monitor and promptly investigate suspected cases of hepatitis A. Public Health is working closely with health care providers to ask them to remain vigilant for hepatitis A. Public Health is also working with organizations that serve people experiencing homelessness to educate the community about the increase in hepatitis A, helping people with symptoms of hepatitis A to encourage medical care to seek care, and to protect themselves by getting vaccinated.

Although the current risk to the public is low, Public Health recommends that residents take the following measures to help prevent the spread of disease:

· Check whether you have been vaccinated against hepatitis A. If not, contact your doctor to determine whether you should be vaccinated. Vaccination is the best way to prevent hepatitis A.

· Wash your hands with soap and water before eating, preparing food and after going to the toilet.

Hepatitis A can range from a mild illness lasting a few weeks to a severe illness lasting several months. Symptoms of hepatitis include fever, nausea, vomiting, abdominal pain, diarrhea, dark urine, or yellow eyes/skin. Although rare, hepatitis A can cause death in some people. Hepatitis A is usually transmitted by eating contaminated food or through close contact with a person who is contagious. A person with the virus can transmit illness up to two weeks before the onset of symptoms.

Areas with poor access to adequate water, sanitation and hygiene services are at high risk of outbreaks.