© Heidi de Marco/Kaiser Health NewsJennifer Millar receives a checkup from a Saban Community Clinic physician assistant.
Jennifer Millar 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.
But this homeless encampment off a Hollywood freeway ramp is often littered with needles and trash and soaked in urine. Rats occasionally scamper through, and Millar fears the consequences.
"I worry about all those diseases," said Millar, 43, who has been homeless most of her life.
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 experienced an outbreak of typhus-a disease spread by infected fleas on rats and other animals-in downtown streets. Officials briefly closed part of City Hall after reporting that rodents had invaded the building.
People
in Washington State have been infected with the diarrheal disease shigella, spread through feces, 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 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."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.
"Typhus," he said. "A medieval disease. In California. In 2019."
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.
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