Communicable Diseases

NEW! Influenza Planning Guides from the CDC

CDC’s Healthcare Preparedness Activity recently published influenza pandemic planning discussion guides for community public health departments, hospitals, and emergency management agencies.

The Health Care of Homeless Persons: A Manual of Communicable Diseases & Common Problems in Shelters & on the Streets

This lavishly illustrated, 384-page manual describes serious health problems that commonly afflict homeless persons and discusses appropriate responses and treatment. The manual addresses communicable disease control and food handling in shelter settings, and current approaches to the management of chronic diseases. It includes convenient patient education materials in English and Spanish that can be easily reproduced and given to shelter guests and staff. The manual is no longer available in print, but you may download it from the Boston Health Care for the Homeless Program website.

Practice Guidelines

• Guide to Infection Prevention for Outpatient Settings: Minimum Expectations for Safe Care (2011) | This document from the Centers for Disease Control & Prevention describes the minimum precautions expected in ambulatory settings regarding the prevention of healthcare-associated infections. Click on the title above to read more about the guidelines and download a copy for free.
• Adapting Your Practice: Treatment and Recommendations for Homeless Patients with HIV/AIDS (2003) | Recommended clinical practice adaptations for the care of individuals with human immunodeficiency virus or acquired immuno-deficiency syndrome who are homeless; developed by clinicians working in HCH projects
• Adapting Your Practice: Treatment and Recommendations for Homeless Patients with Chlamydial or Gonococcal Infections (2008) | Recommended clinical practice adaptations for the care of individuals with these sexually transmitted diseases who are homeless; developed by clinicians working in HCH project
• HIV/AIDS & Homelessness: Recommendations for Clinical Practice & Public Policy (1999) | By John Y. Song, MD
• Combating Tuberculosis & Homelessness: Recommendations for Policy & Practice (1994) | Relevant to the struggle against this significant health threat for homeless persons.

Case Report

Comorbid TB and HIV in a Chronically Homeless Male: Social Isolation Compounds Stress of Medical Confinement (2006) | Homelessness, long recognized as a risk factor for tuberculosis, can also complicate treatment, as this case report demonstrates. HIV coinfection increases the risk of progression from latent TB infection to active tuberculosis. Clinicians experienced in the care of homeless persons stress the importance of maintaining communication with these patients, even during medical confinement, and recommend close collaboration among public health, hospital, and primary care providers throughout the course of treatment.

Healing Hands Articles

• Homeless People at Higher Risk for CA-MRSA, HIV and TB (2006)
• Chronic Hepatitis C: Silent Intruder, Insidious Threat (1999)
• Tuberculosis & Homelessness: Metaphor for Our Time (1999)
• Network to Study HIV and Homelessness (1998)

Ask The Expert

In this column, our expert Ann Petru, MD, Associate Director of Infectious Disease Medicine at Children’s Hospital and Research Center in Oakland, California, answers a question about pediatric HIV/AIDS.

Relevant Articles

• Faricy, L., Page, T., Ronick, M, Rdesinski, R., DeVoe, J. (2012). Patterns of empiric treatment of Chlamydia trachomatis infections in an underserved population. Family Medicine, 44(6): 408-415.

Additional Resources

• Health in Shelters | PowerPoint presentation by Bob Donovan, MD, given at the 2006 National Health Care for the Homeless Conference | Focuses on communicable diseases seen frequently in homeless shelters
• Informed Consent and Agreement to HIV Testing
• Shelters and TB: What Staff Need to Know | An 18-minute video on preventing the spread of tuberculosis in homeless shelters.  It describes what TB is, how it is spread, what to do when staff suspects someone has TB, how to develop and implement a TB infection control policy, and how to work together with the local health department to create a healthy and safe environment for staff and clients.  A viewer’s guide contains main points from the video, tools, checklists and resources that can be put to immediate use. The video and viewer’s guide are available from the Curry International Tuberculosis Center at www.currytbcenter.ucsf.edu.

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