Knowledge and practices related to louse- and flea-borne diseases among staff providing services to people experiencing homelessness in the United States.

Journal: Zoonoses and public health

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Affiliated Institutions:  Epidemic Intelligence Service, Epidemiology and Laboratory Workforce Branch, Division of Workforce Development, National Center for State, Tribal, Local, and Territorial (STLT) Public Health Infrastructure and Workforce, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. Communicable Disease Epidemiology & Immunization Section, Public Health - Seattle & King County, Seattle, Washington State, USA. University of Colorado Anschutz Medical Campus at Colorado State University, Fort Collins, Colorado, USA. Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. Communicable Disease Branch, Colorado Department of Public Health & Environment, Denver, Colorado, USA. Infectious Disease Epidemiology, Prevention, and Control Division, Minnesota Department of Health, Saint Paul, Minnesota, USA. Medical and Preventive Services, Fulton County Board of Health, Atlanta, Georgia, USA. Acute Communicable Disease Control Program, Los Angeles County Department of Public Health, Los Angeles, California, USA. Bureau of Communicable Disease, New York City Department of Health and Mental Hygiene, New York City, New York, USA. Infectious Disease Epidemiology and Outbreak Response Bureau, Maryland Department of Health, Baltimore, Maryland, USA. Office of the Director, Deputy Director for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. Bacterial Diseases Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA.

Abstract summary 

Louse-borne Bartonella quintana infection and flea-borne murine typhus are two potentially serious vector-borne diseases that have led to periodic outbreaks among people experiencing homelessness in the United States. Little is known about louse- and flea-borne disease awareness and prevention among staff who provide services to the population. We surveyed staff in seven US states to identify gaps in knowledge and prevention practices for these diseases.Surveys were administered to 333 staff at 89 homeless shelters and outreach teams in California, Colorado, Georgia, Maryland, Minnesota, New York and Washington from August 2022 to April 2023. Most participants (>68%) agreed that body lice and fleas are a problem for people experiencing homelessness. About half were aware that diseases could be transmitted by these vectors; however, most could not accurately identify which diseases. Less than a quarter of staff could describe an appropriate protocol for managing body lice or fleas. Misconceptions included that clients must isolate or be denied services until they are medically cleared.Our findings reveal significant knowledge gaps among staff who provide services to people experiencing homelessness in the prevention and control of louse- and flea-borne diseases. This demonstrates an urgent need for staff training to both reduce disease and prevent unnecessary restrictions on services and housing.

Authors & Co-authors:  Rich Carpenter Dell Henderson Adams Bestul Grano Sprague Leopold Schiffman Lomeli Zadeh Alarcón Halai Nam Seifu Slavinski Crum Mosites Salzer Hinckley McCormick Marx

Study Outcome 

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Statistics
Citations :  Alarcón, J., Sanosyan, A., Contreras, Z. A., Ngo, V. P., Carpenter, A., Hacker, J. K., Probert, W. S., Terashita, D., Balter, S., & Halai, U. A. (2023). Fleaborne typhus‐associated deaths ‐ Los Angeles County, California, 2022. MMWR. Morbidity and Mortality Weekly Report, 72(31), 838–843. https://doi.org/10.15585/mmwr.mm7231a1
Authors :  23
Identifiers
Doi : 10.1111/zph.13125
SSN : 1863-2378
Study Population
Male,Female
Mesh Terms
Other Terms
Bartonella quintana;Rickettsia typhi;body lice;flea‐borne diseases;louse‐borne diseases;murine typhus;people experiencing homelessness
Study Design
Study Approach
Country of Study
Publication Country
Germany