title: Infectious disease exposures and contact tracing in homeless shelters.
abstract: An outbreak among homeless shelter users of a communicable disease with a short generation time would pose serious public health challenges. Data from Toronto were used to examine the number of shelter residents potentially exposed in the event of such an outbreak. A shelter user had contact with a mean of 97 other residents (range, 1-292) in one day and a mean of 120 (range, 2-624) in eight days. After a single week, contact tracing becomes difficult due to the challenge of locating homeless people who have left the shelter system. Over an 8-day period, individuals who used more than one shelter had contact with an average of 98 more other shelter residents than those who stayed in a single shelter had. At the onset of a serious outbreak, it may be desirable to institute policies that strongly encourage individuals to remain at their current shelter for the duration of the outbreak.
authors.affiliation: Faculty of Medicine, University of Toronto, Ontario, Canada. hwangs@smh.toronto.on.ca
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Hwang
authors.forename: Alex
authors.initials: A
authors.lastname: Kiss
authors.forename: Minnie M
authors.initials: MM
authors.lastname: Ho
authors.forename: Cheryl S
authors.initials: CS
authors.lastname: Leung
authors.forename: Adi V
authors.initials: AV
authors.lastname: Gundlapalli
mesh_terms: D000328:Adult; D002170:Canada; D003140:Communicable Disease Control; D003141:Communicable Diseases / Q000453:epidemiology*; D016358:Contact Tracing / Q000706:statistics & numerical data*; D004196:Disease Outbreaks; D005260:Female; D006703:Ill-Housed Persons; D006801:Humans; D008297:Male