HomeMy WebLinkAboutselect-communicable-diseases-and-infection-control-practices-in-congregate-settings-2023-11-08Select Communicable Diseases and Infection Control
Practices in Homeless Congregate settings
Fundamental Strategies to Prevent Communicable Diseases
1.Have internal process to identify an outbreak
2.Staff educated to recognize specific disease patterns
3.Documenting cases of similar etiology/symptoms with sufficient details to track
source of disease outbreak
4.Rapidly implementing control measures to stop the spread based on mode of
transmission of suspected infectious disease including isolation, PPE use, hand
hygiene, cleaning and disinfection
5.Notification to local health department of an outbreak to secure expertise and
help in managing the outbreak
MRSA Prevention (skin and soft tissue infections):
ACPHD/ACHCH Select Communicable Diseases for Homeless Providers 11-8-2023
6.Antibiotic stewardship: Implement antibiotic stewardship programs to prevent the
overuse or misuse of antibiotics, which can lead to the development of antibiotic-
resistant bacteria like MRSA.
By implementing these prevention strategies, you can help reduce the spread of MRSA
in congregate settings.
How to treat MRSA in homeless population?
Treating MRSA in homeless individuals can be challenging because of various factors
such as poor hygiene, lack of access to medical care, and frequent movement between
shelters or living on the streets. Here are some steps that can be taken to treat MRSA in
homeless individuals:
1.Seek medical attention: Homeless individuals with MRSA should seek medical
attention as soon as possible. A healthcare provider can diagnose MRSA and
determine the appropriate treatment plan.
2.Antibiotics: Antibiotics are often used to treat MRSA. Depending on the severity
of the infection, antibiotics can be given orally or intravenously. The length of
treatment varies depending on the individual case.
3.Wound care: MRSA infections often cause skin abscesses, so proper wound
care is crucial. This includes cleaning the infected area, draining the abscess if
necessary, and keeping the area covered and dry.
4.Supportive care: Homeless individuals with MRSA may require additional
supportive care such as pain management and nutritional support. It's important
to address any underlying medical conditions that may affect healing.
5.Education: Educate homeless individuals about MRSA, how it spreads, and how
to prevent it. This can include proper hand hygiene, covering wounds, and
avoiding sharing personal items.
6.Housing: In addition to medical treatment, providing stable housing can help
prevent the spread of MRSA in homeless populations. Access to housing can
also provide a stable environment for wound care and medication management.
The choice of antibiotic used to treat MRSA wounds depends on the severity of the
infection, the location of the infection, and the patient's medical history and allergies.
Some antibiotics that are commonly used to treat MRSA infections include:
1.Vancomycin: This is one of the most commonly used antibiotics for MRSA
infections. It is usually given intravenously and can be effective against many
strains of MRSA.
2.Linezolid: This antibiotic is effective against MRSA and is usually given orally or
intravenously. It is often used to treat skin and soft tissue infections caused by
MRSA.
ACPHD/ACHCH Select Communicable Diseases for Homeless Providers 11-8-2023
3.Daptomycin: This antibiotic is usually given intravenously and can be effective
against MRSA infections that are resistant to other antibiotics.
4.Clindamycin: This antibiotic is often used to treat MRSA skin infections,
especially when the infection is located in an area where surgery is not feasible.
5.Trimethoprim-sulfamethoxazole (TMP-SMX): This antibiotic combination is often
used to treat MRSA skin and soft tissue infections, as well as some types of
pneumonia caused by MRSA.
It is important to note that MRSA strains can be resistant to multiple antibiotics, and the
choice of antibiotic should be made in consultation with a healthcare provider who can
take into account the patient's medical history and current health status. Additionally,
proper wound care, including cleaning the wound and changing dressings frequently, is
essential to prevent MRSA infections from developing or spreading.
Preventing MRSA outbreaks in homeless shelters:
Preventing MRSA outbreaks in homeless shelters can be challenging, but there are
several steps that can be taken to minimize the risk of transmission:
1.Increase hygiene: Encourage frequent handwashing and provide hand sanitizer
throughout the shelter. Promote good personal hygiene, such as showering and
changing clothes regularly, especially among those who are infected or at risk of
infection.
2.Educate staff and residents: Provide training for staff and residents on MRSA, its
symptoms, and how to prevent transmission. Encourage staff to report any
suspected cases to management immediately.
3.Screen and isolate infected individuals: Screen all new residents for MRSA and
isolate those who are infected to prevent the spread of the bacteria. Consider
providing separate sleeping quarters for those infected until they have recovered.
4.Clean and disinfect: Regularly clean and disinfect high-touch surfaces, such as
doorknobs, light switches, and shared bathroom areas. Use EPA-registered
disinfectants that are effective against MRSA.
5.Implement infection control measures: Consider implementing infection control
measures such as cohorting, where residents who are infected or at risk of
infection are grouped together in the same area. This can help to limit the spread
of MRSA.
6.Reduce overcrowding: Reduce overcrowding in the shelter as much as possible
to minimize the risk of transmission. Consider partnering with other organizations
to provide additional shelter space.
7.Encourage vaccinations: Encourage staff and residents to get vaccinated against
preventable illnesses, such as the flu, which can weaken the immune system and
increase the risk of MRSA infection.
8.Avoid sharing personal items: Avoid sharing personal items, such as towels,
clothing, or razors, with others to prevent the spread of MRSA.
9.Clean wound, cover the wounds with sterile dressings, change dressings
frequently to avoid cross contamination with MRSA
By implementing these measures, homeless shelters can minimize the risk of MRSA
outbreaks and help to keep residents safe and healthy.
Diarrheal Infections:
Diarrheal infections can spread quickly in homeless shelters due to the close living
quarters and poor hygiene. Here are some steps that can be taken to prevent and
manage diarrhea outbreaks in homeless shelters:
1.Promote good hygiene: Encourage frequent hand washing with soap and water
or use of hand sanitizer. Provide access to clean water and soap and display
posters with instructions on how to wash hands properly.
2.Educate staff and residents: Provide education to staff and residents on how
diarrheal infections spread and how to prevent them. Encourage staff to report
any cases of diarrhea to management immediately.
3.Isolate those infected: Isolate anyone with diarrhea symptoms from the general
population until they are symptom-free for at least 48 hours. Consider providing
separate bathroom facilities for those with diarrhea symptoms.
4.Clean and disinfect: Regularly clean and disinfect high-touch surfaces, such as
doorknobs, light switches, and bathroom facilities. Use EPA-registered
disinfectants that are effective against diarrhea-causing pathogens.
5.Provide safe food and water: Ensure that the food and water provided in the
shelter are safe to consume. Regularly test water sources to ensure they are free
of contaminants.
6.Encourage vaccination: Encourage staff and residents to get vaccinated against
preventable illnesses, such as the flu and rotavirus, which can cause diarrhea.
7.Partner with local health agencies: Work with local health agencies to develop an
outbreak response plan and to receive guidance on managing outbreaks of
diarrheal infections.
By implementing these measures, homeless shelters can minimize the risk of diarrheal
infections and help to keep residents safe and healthy.
Types of Diarrheal Infections:
Several microorganisms can cause diarrheal diseases in homeless shelters. The most
common ones include:
1. Norovirus: This is the most common cause of acute gastroenteritis in the general
population and is highly contagious. It spreads easily in crowded environments,
such as homeless shelters, through contaminated surfaces, food, or water.
2. Salmonella: This bacterium can cause foodborne illness and is commonly found
in raw or undercooked meat, poultry, eggs, and dairy products. It can also be
spread through contact with contaminated surfaces or fecal matter.
3. Shigella: This bacterium causes a severe form of diarrhea known as shigellosis.
It is spread through contaminated food, water, or surfaces, or through person-to-
person contact.
4. Campylobacter: This bacterium is commonly found in raw or undercooked
poultry, unpasteurized milk, and contaminated water. It can cause a severe form
of diarrhea known as campylobacteriosis.
5. Escherichia coli (E. coli): Some strains of E. coli can cause diarrhea and other
gastrointestinal symptoms. It is often spread through contaminated food or water.
6. Cryptosporidium: This parasite can cause cryptosporidiosis, a diarrheal illness
that can be severe in people with weakened immune systems. It is spread
through contact with contaminated water, food, or surfaces.
Preventing the spread of these microorganisms requires proper hygiene, sanitation, and
food safety measures, as well as prompt identification and isolation of infected
individuals.
Treatment of Diarrheal Infections:
The use of antibiotics for the treatment of diarrheal diseases depends on the cause of
the illness. Antibiotics are only effective against bacterial infections, and they are not
effective against viral or parasitic infections. Here are some antibiotics that may be used
to treat specific bacterial causes of diarrhea:
1. Azithromycin: This antibiotic is often used to treat Campylobacter infections.
2. Ciprofloxacin: This antibiotic is effective against many types of bacteria that
cause diarrhea, including Campylobacter, Shigella, and Salmonella.
3. Trimethoprim-sulfamethoxazole (TMP-SMX): This antibiotic is often used to treat
Shigella and some strains of E. coli.
4. Metronidazole: This antibiotic is effective against some types of bacterial
infections, such as Clostridium difficile, and some parasitic infections.
5. Prescribe anti-parasitic medication: The medication of choice for giardiasis is
usually metronidazole, tinidazole, or nitazoxanide. The medication is usually
taken for 5-10 days.
It is important to note that antibiotics should only be used to treat bacterial infections
and only under the guidance of a healthcare professional. Inappropriate use of
antibiotics can lead to the development of antibiotic-resistant bacteria, which can be
difficult to treat. In addition, antibiotics may cause side effects and should only be used
when necessary.
Preventing Diarrheal Diseases in Homeless Shelters:
Preventing diarrheal outbreaks in homeless shelters requires a multi-faceted approach
that includes improving hygiene practices, ensuring safe food and water sources, and
identifying and managing outbreaks early. Here are some steps that can be taken to
prevent diarrheal outbreaks in homeless shelters:
1. Practice good hygiene: Encourage residents, staff, and volunteers to practice
good hand hygiene by washing hands frequently with soap and water or using
hand sanitizer. Promote proper hygiene practices, such as covering coughs and
sneezes, and avoiding close contact with people who are sick.
2. Ensure safe food and water sources: Provide access to safe food and water
sources, and ensure that all food is prepared and stored properly to prevent
contamination. Regularly inspect and clean kitchen and food storage areas.
3. Manage outbreaks early: Be alert for signs of diarrheal outbreaks, such as an
increase in cases of diarrhea, and implement outbreak control measures
promptly. Isolate individuals with diarrhea and investigate the source of the
outbreak.
4. Improve sanitation: Ensure that the shelter is kept clean and disinfected, with
particular attention paid to high-touch surfaces and areas where food is prepared
and served.
5. Provide access to healthcare: Provide access to healthcare services for residents
who are ill and track and trend cases to monitor for outbreaks.
Food-borne Diseases:
Food-borne infections are a significant health risk in homeless shelters, where access to
safe food and water may be limited. Some common food-borne infections that can occur
in homeless shelters include Salmonella, E. coli, and norovirus. Here are some steps
that can be taken to prevent food-borne infections in homeless shelters:
1. Ensure safe food handling practices: Train staff and volunteers on safe food
handling practices, including proper hand hygiene, food storage, and cooking
temperatures. Regularly inspect and clean kitchen and food storage areas.
2. Monitor food sources: Ensure that all food sources are safe and reputable, and
monitor food shipments and storage to prevent contamination. Discard any food
that is past its expiration date or shows signs of spoilage.
3. Promote proper hygiene practices: Encourage residents, staff, and volunteers to
practice good hand hygiene, and provide access to hand sanitizer and hand-
washing stations.
4. Monitor for outbreaks: Monitor for signs of food-borne illnesses and outbreaks,
such as an increase in cases of diarrhea or vomiting, and investigate promptly.
Isolate individuals who are ill and implement outbreak control measures.
5. Provide access to healthcare: Provide access to healthcare services for residents
who are ill, and monitor for outbreaks.
It is important to note that preventing food-borne infections in homeless shelters
requires ongoing effort and attention to safe food handling practices, hygiene, and
outbreak control measures. Regular training and education, along with close monitoring
of outbreaks, can help prevent and control food-borne illnesses in homeless shelters.
Types of food-borne diseases in homeless shelters:
Several different microorganisms can cause food-borne diseases in homeless shelters,
including:
1. Salmonella: This bacterium is commonly found in contaminated food, especially
poultry and eggs. Symptoms of salmonella infection include fever, diarrhea, and
abdominal cramps.
2. E. coli: Certain strains of E. coli can cause severe illness, especially in individuals
with weakened immune systems. Symptoms include diarrhea, abdominal pain,
and fever.
3. Norovirus: This highly contagious virus can spread rapidly in crowded settings
like homeless shelters. It causes symptoms such as vomiting, diarrhea, and
stomach cramps.
4. Staphylococcus aureus: This bacterium can produce a toxin in food that causes
rapid onset of symptoms like vomiting and diarrhea.
5. Clostridium perfringens: This bacterium can grow in cooked foods that are left at
room temperature for too long, producing a toxin that can cause diarrhea and
abdominal pain.
6. Listeria: This bacterium can grow in refrigerated foods and can cause severe
illness in pregnant women and individuals with weakened immune systems.
Symptoms include fever, muscle aches, and gastrointestinal symptoms.
7. Botulinum toxin is a type of neurotoxin produced by the bacterium Clostridium
botulinum. It is one of the most potent toxins known, and can cause severe
illness or even death if ingested in sufficient quantities. The toxin can be found in
foods that have been improperly processed or stored, especially those that are
low-acid and have been canned or vacuum-packed.
8. Brucella is a type of bacteria that can cause food-borne infections in humans.
The most common route of transmission is through the consumption of
contaminated dairy products, such as unpasteurized milk and cheese made from
unpasteurized milk. Brucella bacteria, can cause symptoms such as fever,
fatigue, headache, muscle and joint pain, and loss of appetite. In severe cases, it
can lead to complications such as arthritis and inflammation of the heart and
brain.
Treatment of Food-borne diseases:
The treatment of food-borne diseases depends on the specific type of infection and its
severity. In general, the following measures may be recommended:
1. Fluid and electrolyte replacement: Diarrhea and vomiting can cause dehydration
and electrolyte imbalances. Treatment may involve replenishing fluids and
electrolytes through oral rehydration solutions or, in severe cases, intravenous
fluids.
2. Antibiotics: If the food-borne infection is caused by bacteria, antibiotics may be
prescribed to treat the infection. However, antibiotics are not effective against
viral infections, and may not be necessary in all cases of bacterial infections.
3. Antiemetics: Medications that can help relieve nausea and vomiting may be
prescribed or recommended.
4. If you have a suspected or confirmed food-borne illness, it is important to avoid
preparing food for others until you have fully recovered to prevent further spread
of the infection.
Preventing food-borne diseases in homeless shelters:
Preventing food-borne diseases in homeless shelters involves implementing measures
to ensure safe food handling, preparation, and storage. Here are some ways to prevent
food-borne diseases in homeless shelters:
1. Train staff: Staff should be trained on safe food handling practices, such as hand
hygiene, temperature control, and avoiding cross-contamination.
2. Maintain a clean environment: A clean environment can help prevent the growth
and spread of harmful bacteria. Surfaces, utensils, and equipment should be
cleaned and sanitized regularly.
3. Control temperature: Proper temperature control is important to prevent the
growth of harmful bacteria. Food should be stored at the appropriate temperature
and cooked to the proper temperature.
4. Source safe food: Food should be sourced from reputable suppliers and
inspected upon arrival to ensure that it is safe for consumption.
5. Implement a food safety plan: A food safety plan should be in place that outlines
procedures for food handling, preparation, and storage. The plan should be
reviewed regularly and updated as needed.
6. Educate residents: Residents should be educated on safe food handling
practices, such as washing hands before eating and avoiding cross-
contamination.
7. Monitor for illness: Staff should monitor residents for signs of illness, and any
resident with suspected food poisoning should be isolated and referred for
medical attention.
Aerosol Transmitted Diseases:
Aerosol transmission occurs when respiratory droplets containing infectious agents are
produced by an infected individual through coughing, sneezing, or talking, and then
inhaled by a susceptible individual. Aerosol transmission can occur over short distances
(less than 1 meter) or over longer distances (up to several meters) and is a known route
of transmission for several diseases.
Here are some examples of diseases that can be transmitted through aerosols:
1. COVID-19: COVID-19 is primarily transmitted through respiratory droplets, which
can be inhaled by another person. However, there is also evidence to suggest
that the virus can remain airborne in certain circumstances and be transmitted
through aerosols.
2. Tuberculosis: Tuberculosis (TB) is a bacterial infection that primarily affects the
lungs. TB is spread through the air when an infected person coughs, sneezes, or
talks, and another person inhales the bacteria.
3. Measles: Measles is a highly contagious viral infection that spreads through the
air when an infected person coughs or sneezes.
4. Influenza: Influenza is a viral infection that spreads through the air when an
infected person coughs or sneezes.
5. Legionnaires' disease: Legionnaires' disease is a type of pneumonia that is
caused by the bacterium Legionella pneumophila. The bacteria can be found in
water systems, and the disease is transmitted through inhalation of aerosols
containing the bacteria.
6. Coccidioidomycosis, also known as valley fever, is a fungal infection caused by
the fungus Coccidioides immitis or Coccidioides posadasii. This fungus is
commonly found in soil in arid and semi-arid regions, such as the southwestern
United States, Central and South America, and parts of Africa.
Coccidioidomycosis is primarily a respiratory infection that is contracted by
inhaling fungal spores from the soil.
To prevent the transmission of aerosol-transmitted diseases, it is important to practice
good respiratory hygiene, such as covering the mouth and nose when coughing or
sneezing, and avoiding close contact with people who are sick. Proper ventilation and
air filtration can also help reduce the risk of transmission. In healthcare settings,
personal protective equipment (PPE) such as masks and respirators can help prevent
the spread of aerosol-transmitted diseases.
Types of aerosol transmitted diseases in homeless shelters:
There are several types of aerosol-transmitted diseases that can be of concern in
homeless shelters. Some of these diseases include:
1. Tuberculosis (TB): TB is a bacterial infection that can be spread through the air
when an infected person coughs or sneezes. Homeless individuals may be at
increased risk for TB due to poor living conditions and compromised immune
systems.
2. Influenza: Influenza is a viral infection that can be spread through the air when an
infected person coughs or sneezes. Homeless individuals may be at increased
risk for influenza due to poor living conditions and close contact with others in
shelters.
3. COVID-19: COVID-19 is a viral infection caused by the SARS-CoV-2 virus that
can be spread through the air when an infected person coughs, sneezes, or
talks. Homeless individuals may be at increased risk for COVID-19 due to close
living quarters and limited access to healthcare.
4. Measles: Measles is a highly contagious viral infection that can be spread
through the air when an infected person coughs or sneezes. Homeless
individuals may be at increased risk for measles due to close living quarters and
limited access to healthcare.
5. Pertussis: Pertussis, also known as whooping cough, is a bacterial infection that
can be spread through the air when an infected person coughs or sneezes.
Homeless individuals may be at increased risk for pertussis due to poor living
conditions and limited access to healthcare.
Preventing the spread of aerosol-transmitted diseases in homeless shelters requires a
multi-pronged approach that includes providing adequate ventilation, promoting good
respiratory hygiene (such as covering coughs and sneezes), promoting hand hygiene,
and encouraging vaccination against preventable diseases such as influenza and
measles. Providing access to healthcare and housing can also help reduce the risk of
disease transmission among homeless individuals.
Treatment of aerosol transmitted diseases:
The treatment for aerosol-transmitted diseases depends on the specific disease and its
severity. Some common treatments for these diseases include:
1. Antibiotics: Antibiotics are often used to treat bacterial infections such as
tuberculosis and pertussis.
2. Antivirals: Antiviral medications may be used to treat viral infections such as
influenza and COVID-19.
3. Supportive care: In some cases, supportive care such as oxygen therapy,
intravenous fluids, and rest may be necessary to help the body fight off the
infection.
4. Vaccines: Vaccines are available for some aerosol-transmitted diseases such as
influenza and measles. These vaccines can help prevent infection and reduce
the severity of symptoms in those who do become infected.
Preventing aerosol transmitted diseases min homeless shelters:
Preventing the transmission of aerosol-transmitted diseases in homeless shelters can
be challenging, but there are several measures that can be taken to reduce the risk of
infection. Some of these measures include:
1. Adequate ventilation: Ensuring that the shelter has proper ventilation can help
reduce the concentration of infectious particles in the air.
2. Promoting respiratory hygiene: Encouraging residents and staff to cover their
mouths and noses when coughing or sneezing can help reduce the spread of
infectious particles in the air.
3. Promoting hand hygiene: Providing access to hand hygiene facilities such as
hand sanitizer and soap and water can help reduce the spread of infection.
4. Encouraging vaccination: Encouraging residents and staff to get vaccinated
against preventable diseases such as influenza and measles can help reduce the
spread of infection.
5. Providing education: Providing education on the signs and symptoms of
infectious diseases and how they are spread can help residents and staff
recognize and report potential cases.
6. Isolation and quarantine: Isolating or quarantining individuals who are sick or at
risk of infection can help reduce the spread of infectious particles in the air.
7. Providing adequate healthcare: Providing access to healthcare can help ensure
that residents receive prompt diagnosis and treatment for infectious diseases,
reducing the risk of transmission.
Infestations in Homeless Shelters:
Infestations in homeless shelters can pose a serious health risk to residents and staff.
Some of the most common infestations in homeless shelters include bed bugs, lice,
Scabies, fleas, and rodents. These infestations can cause skin irritation, allergic
reactions, and the spread of disease. Here are some steps that can be taken to prevent
and control infestations in homeless shelters:
1. Regular cleaning and maintenance: Regular cleaning and maintenance can help
prevent infestations by removing potential sources of food and shelter for pests.
2. Inspection and monitoring: Regular inspection and monitoring can help detect
infestations early, allowing for prompt action to be taken to control them.
3. Proper storage of food and waste: Proper storage of food and waste can help
prevent infestations by denying pests access to potential sources of food.
4. Pest control measures: Pest control measures such as insecticides, traps, and
bait stations can be used to control infestations once they are detected.
5. Collaboration with local health authorities: Collaborating with local health
authorities can help ensure that appropriate measures are taken to control
infestations and prevent the spread of disease.
Types of infestations in homeless shelters:
There are several types of parasites that can cause infestations in homeless shelters.
Some of the most common parasites include:
1. Bed bugs: Bed bugs are small insects that feed on human blood. They are
typically found in bedding and furniture and can cause skin irritation and allergic
reactions.
2. Lice: Lice are small insects that live on human hair and feed on blood. They can
cause itching and skin irritation and are easily spread from person to person.
3. Fleas: Fleas are small insects that feed on blood and are typically found on pets
or wild animals. They can also infest human homes and shelters and cause
itching and skin irritation.
4. Scabies: Scabies is a skin infestation caused by tiny mites that burrow into the
skin. It can cause intense itching and a rash, and is easily spread through skin-
to-skin contact.
5. Head and body lice: Head and body lice are parasites that live on the human
scalp and body hair, respectively. They feed on human blood and can cause
itching and skin irritation.
6. Tapeworms: Tapeworms are intestinal parasites that can be spread through the
ingestion of contaminated food or water. They can cause diarrhea, abdominal
pain, and weight loss.
7. Pinworms: Pinworms are intestinal parasites that are easily spread through close
contact with infected individuals. They can cause itching around the anus and
irritability.
Treatment for various infestations in homeless shelters:
The treatment for parasites causing infestations in homeless shelters depends on the
type of parasite and the extent of the infestation. In general, the following treatments
may be recommended:
1. Bed bugs: Bed bugs can be treated with insecticides that are applied directly to
infested areas or furniture. Infested bedding and clothing should be washed and
dried on high heat.
2. Lice: Lice can be treated with medicated shampoos or lotions that kill the lice and
their eggs. Bedding, clothing, and other personal items should be washed in hot
water and dried on high heat.
3. Fleas: Fleas can be treated with insecticides that are applied to infested areas or
pets. Infested bedding and clothing should be washed and dried on high heat.
4. Scabies: Scabies can be treated with medicated creams or lotions that kill the
mites. All clothing, bedding, and towels should be washed in hot water and dried
on high heat. Permethrin cream is the most commonly prescribed medication for
scabies or oral Ivermectin in severe cases
5. Head and body lice: Head and body lice can be treated with medicated
shampoos or lotions that kill the lice and their eggs. All clothing and bedding
should be washed in hot water and dried on high heat.
6. Tapeworms: There are several medications that can be used to treat tapeworms,
including praziquantel, niclosamide, and albendazole. These medications work
by killing the tapeworm in the intestines. The medication prescribed will depend
on the type of tapeworm and the severity of the infection. Also avoid
undercooked meats.
7. Pinworms: Pinworms can be treated with medications that kill the worms. All
bedding and clothing should be washed in hot water and dried on high heat. The
most common medications used to treat pinworms are mebendazole,
albendazole, and pyrantel pamoate.
Preventing parasitic infestation in homeless shelters:
Preventing parasitic infestations in homeless shelters can be challenging, but there are
some measures that can be taken to reduce the risk of infestation. Here are some ways
to prevent parasitic infestations in homeless shelters:
1. Good hygiene: Encourage all residents to practice good personal hygiene, such
as washing hands regularly with soap and water, keeping nails short, and
avoiding sharing personal items like towels and combs.
2. Cleaning and disinfecting: Regularly clean and disinfect common areas, including
bathrooms, showers, and sleeping areas. Use appropriate disinfectants to kill
parasites and their eggs.
3. Screening: Screen residents for parasitic infestations upon entry to the shelter
and regularly thereafter. Any individuals found to be infected should be treated
and isolated until they are no longer contagious.
4. Pest control: Implement effective pest control measures to prevent infestations of
insects or rodents that may carry parasites.
References:
1. National Healthcare for the Homeless Council: The National Healthcare for
the Homeless Council is a national organization that provides resources and
support to healthcare providers who work with homeless populations. Their
website provides access to a wide range of tools and resources for healthcare
providers, including clinical guidelines, training materials, and research.
2. Healthcare and Housing Collaboration: A Guidebook for the Homeless: This
guidebook, produced by the US Department of Housing and Urban Development,
provides guidance on how to establish effective partnerships between healthcare
providers and housing providers to improve health outcomes for homeless
individuals.
3. Health Care for the Homeless Clinicians' Network: The Health Care for the
Homeless Clinicians' Network is a network of healthcare providers who work with
homeless populations. They provide a range of resources and support for
healthcare providers, including clinical guidelines, research, and training
materials.
4.The Joint Commission: The Joint Commission is a national organization that
accredits healthcare organizations in the United States. They provide guidelines
and standards for healthcare providers who work with homeless populations,
including recommendations for providing culturally competent care, ensuring
patient safety, and improving access to care.
5.SAMHSA Homeless Resource Center: The Substance Abuse and Mental
Health Services Administration (SAMHSA) Homeless Resource Center provides
a range of resources and support for healthcare providers who work with
homeless populations, including clinical guidelines, training materials, and
research.
Appendix A:
TABLE OF COMMUNICABLE DISEASES
Disease Signs & symptoms Incubation Communicability Prevention
Chicken pox – Esp seen winter & spring. Resp 10-21 days Thru inhalation of Mask patient. Provider
varicella zoster symptoms, malaise (not feeling well), airborne droplets should avoid contact if
virus; viral low-grade fever followed by rash & direct contact they’ve never had
disease starting on face & trunk spreading to of weeping chicken pox.
rest of body. Fluid filled vesicles lesions & Vaccination now
rupture & scab over within 1 week. contaminated available (1995) and
part linens. of childhood
immunizations. Pt
isolated until all lesions
crusted over and dry.
Hepatitis – Signs & symptoms generally same for Acute or Chronic
incubation varies
Contact with blood and
body fluids ( Hep A
transmits via oral-fecal
contamination)
Most important is
inflammation of all forms: avoidance of contact
the liver due to Headache; fever; weakness; joint with blood and body
multiple causes pain; anorexia; nausea; vomiting; fluids of all persons.
(virus most RUQ pain; jaundice; dark urine; clay-
common) colored stools
Hepatitis A – May have no symptoms. Adults may 15-50 days;Fecal-oral route. Vaccines in active areas
infectious or viral have abdominal pain, loss of appetite, average 30 days.Virus lasts on (active immunity). Good
nausea, diarrhea, light colored stools, Disease follows hands about 4 handwashing.
dark urine, fatigue, fever & jaundice. mild course &hours. More
Hepatitis B – It can take 1-9 months before 4-25 weeks;Direct contact Vaccination 90%
serum hepatitis symptoms develop. Some have mild average 8-12 (blood, semen, effective. Virus stable on
flu-like symptoms. Dark urine, light weeks vaginal fluid, surfaces with dried
blood colored stools, fatigue, fever & saliva). Can for 7 days.
jaundice. Can develop acute hepatitis, become
cirrhosis, liver cancer. asymptomatic
chronic carrier
capable of
transmitting
disease to others.
Hepatitis C Chronic condition in 85% of infected 2-25 weeks; avge Contact with Since 1989 screen
bloodLeading cause of people. Liver fibrosis into cirrhosis in 7-9 weeks.infected blood for HCV. No vaccine
duecirrhosis & liver
cancer.
20% of infected people. Disease may be
dormant 10-20 years
before symptoms.
primarily with IV
drug use &
sexual contact.
to high mutation rate.
HIV – a virus that Mono-like syndrome, fatigue, fever, Variable. May Bloodborne Universal standard
attacks the sore throat, lymphadenopathy, develop through blood & precautions
immune system & splenomegaly, rash, diarrhea. Skin detectable body fluids
causes AIDS (a lesions (Kaposi’s sarcoma); antibodies 1-3 Death is usually from
the collection of signs opportunistic infections (Pneumocystic months. Variable opportunistic diseases
& symptoms) carinii pneumonia, Tb) time from HIV that take advantage of
infection to the patient’s weakened
diagnosis of systems.
AIDS.
Influenza (flu) Epidemics usually in winter. Sudden 1-4 days Direct contact Vaccination available
onset fever for 3-5 days, chills, especially in annually; most effective
Viral disease tiredness, malaise (not feeling well), Peak flu season crowded areas if received from
musculoskeletal aches, nasal is late December via droplets. The September to mid-
discharge, dry cough, mild sore throat. through March. virus can persist November.
Children can also experience GI on surfaces for Treatment is
symptoms of nausea, vomiting & hours but indirect symptomatic (rest,
fluids, diarrhea although this is uncommon in contact is less OTC med for fever &
Measles
(rubeola, hard
measles)
Initially symptoms of severe cold with
fever, conjunctivitis, swollen eyelids,
photophobia, malaise, cough,
nasopharyngeal congestion, red
bumpy rash lasting about 6 days
7-14 days;
average 10 days
Inhalation of
infective droplets
& direct contact.
Highly
communicable
virus mostly
before prodrome
starts (early or
impending
disease time), to
about 4 days after
rash appears.
Handwashing critical.
MMR vaccination part
of childhood program.
Meningitis –
inflammation of
meninges caused
by bacteria &
viruses
Viral meningitis – most common type
of meningitis; self-limited disease
lasting 7-10 days.
Bacterial – Neisseria meningitides
bacteria causes very serious
infection; fever, chills, headache,
nuchal rigidity (stiff neck) with flexion,
arthralgia (achy joints), lethargy,
malaise (ill feeling), altered mental
status, vomiting, seizures.
2-4 days up to 10
days
Resp droplets;
contact with oral
secretions,
crowding, close
contact, smoking,
lower
socioeconomic
status. Viral
meningitis can
also be spread via
contact with feces
of infected person.
Practice good
handwashing. Mask
for pt and self.
Universal precautions.
Post exposure
antibiotics started
within 24 hours.
Vaccination now part
of childhood series
(Haemophilus
influenza type B).
Avoid crowded places
Monkeypox Rare viral disease. 12 days after
exposure get fever, headache, muscle
aches, backache, swollen lymph
nodes, tired. Rash 1-3 days after
fever; often starts on face as fluid
filled bumps & the spreads.
12 days From an animal
with monkeypox
if bitten or touch
the animal’s
Person-to-person
from large
respiratory droplets during
long periods of
face-to-face contact w/rash
No specific
treatment.
Vaccinations are
best options of high
risk population.
MRSA – Usually found in ill patients who are Usually spread Handwashing after any
methicillin multidrug resistant. Often in open from infected patient contact. Wear
resistant wounds, post-op wounds, around G- patients via gloves when doing pt
staphylococcus tube sites. hands of HCW & contact. Protective
aureus inanimate objects gowns when in contact
(B/P cuff, with infected linens.
stethoscope). Avoid sharing of
equipment. HCW can
be colonized with MRSA
(not common) but often
are not ill & are not at
risk to other healthy
persons (peers, family).
Pertussis –
whooping cough
1st phase – common cold
symptoms lasts 1-2 weeks. 2nd
phase lasts month or longer. No
fever. Mild cough that can become
severe & violent, productive. 3rd
phase – frequency and severity of
coughing decreases.
6-20 days Transmitted via
respiratory
secretions or in an
aerosolized form.
Highly contagious
except in 3rd phase.
Communicability
greatest before 2nd
phase.
Mask pt.
DPT vaccination in
childhood series (not
sure how long
immunity lasts).
Diarrheal
Diseases
Acute onset of diarrhea,
abdominal cramps, bloody
diarrhea, dehydration, loose
watery stool, fevers
Few hours to few
days
Through contact with
stool, aerosolized
projectile
vomiting(Norovirus)
Frequent Hand
Washing
Disinfection of
contaminated surfaces
Safe food products
Food-borne
Diseases
Watery diarrhea, Fevers,
Abdominal cramping,
Few hours to few
days
Contaminated food,
food toxins from
improperly preserved
or uncooked food
Safe food storage
Maintaining proper
temperature for
cooking/storing food,
frequent Hand
Hygiene
Scabies A parasitic disease of skin caused by 2-6 weeks before Transmitted skin Educate on mode of
a mite. Penetration is visible as onset of itching.to skin contact. transmission & need for
papules, vesicles, or tiny linear Reexposure –Transfer from early diagnosis & tx. No
burrows containing mites & their eggs. symptoms underwear & work or school until day
Lesions prominent around finger develop in 1-4 bedclothes only if after tx started. Contact
webs, anterior surfaces of wrists & days.immediate isolation. Disinfection for
elbows, anterior axillary folds, belt contact. clothes & bed sheets
line, thighs, external genitalia in men, Communicable used 48 hours prior to
nipples & abd & lower portion of until eggs & mites start of tx. Tx is a topical
buttocks in women. Itching intense are destroyed by solution.
esp at night. Complications limited to tx, ordinarily 1 or
lesions that get infected from occasionally 2
scratching. courses of tx 1
week apart.
Tuberculosis-MTB
(MTB)
Primarily affects resp system. May 4-12-weeks Most commonly Universal precautions.
Aerosol transmitted
diseases
spread to other organ systems. Persons most through airborne Mask pt and self. The
Development of disease about 6-12 susceptible: HIV,resp droplets. N95 mask required
months after infection. Chills, fever, close contact with Repeated Around TB patient.
fatigue, productive or non-productive TB pt,exposure is Skin test annually. If the
chronic cough, weight loss, night immunocompro-generally TB skin test is positive,
sweats, hemoptysis. mised, foreign necessary to May signal active disease
TB infection – person has the borne in country become infected
bacteria but are not sick & not capable with high TB rate,so prolonged
of spreading the disease. May Some HCW &exposure
become ill if health status changes. prison guards,increases risk. Patient can be treated AntibioticsMay be treated prophylactically for malnourished,
now. ETOH & drug
TB disease – person ill, is capable of
Transmitting via aerosolized droplets from lungs
Users.
spreading the disease. Needs meds.
ACPHD/ACHCH Selected Communicable Disease for Homeless Services Providers 11-8-2023