Three cases of a bacteria-caused illness among Boston’s homeless—including one that proved fatal—occurred in less than two months, prompting the Boston Healthcare for the Homeless Program to vaccinate 990 shelter clients and staff workers. The illness, meningococcemia, is not usually the cause of widespread outbreaks among homeless individuals, but health experts note that shelter conditions do make it easier for the disease to spread.
“Because of the big unusual clustering this infection, the [Boston Public Health] Commission recommended we embark on a mass vaccination of as many homeless individuals as possible using the shelter system” said Dr. Denise De Las Nueces, the Medical Director of the Boston Health Care for the Homeless Program. She noted that this is the first such clustering of meningococcemia that both she and the Commission have seen.
The death of one man from meningococcemia last Tuesday raised health concerns, and the Boston Public Health Commission strongly advised shelter clients get vaccinated against the disease.The state itself provided over 1,000 doses of the vaccine to the BHCHP and cooperating parties to be administered at shelters across Boston.
While it can be complicate to coordinate moving parts like shelters and government agencies, Dr. De Las Nueces says “The process has been smooth, or at least as smooth as it can be.”
Prior to Tuesday, two other cases of meningococcemia were spotted in late January, but both infected individuals survived. Due to the timing and fact that they were infected by the same strain of the bacteria, it’s believed the first two cases were linked. In response, antibiotics were given out to clients and staff who may have been exposed. Since the most recent case was infected by a different strain, it’s believed to be unrelated to the first two.
Meningococcemia isn’t highly contagious. As the Boston Public Health Commission told the The Boston Globe, which broke the story, the illness is most often spread through saliva or by staying “within 3 to 6 feet of an ill individual for several hours.” Further, the Globe notes that “illnesses are caused by a bacterium called Neisseria meningitidis, which live harmlessly in many people’s noses and throats. But the germs sometimes invade the lining of the brain and spinal cord, causing meningitis, or get into the bloodstream, causing meningococcemia.” However, there’s no clear reason why the bacterium relocates, though smokers may be more at risk.
Dr. De Las Nueces also told Spare Change News that people in congregated living conditions are more prone to outbreaks—it’s common on college campuses, for example. Since shelters are often crowded—and with winter overflow packing even more clients in closer together—they provide environments in which Dr. De Las Nueces says the illness has a better chance of spreading.
Health officials stress that vaccinations are the best prevention—however, they aren’t mandatory for shelter guests. “The goal is always prevention,” says Dr. De Las Nueces. She adds that meningococcemia can be treated with antibiotics if it’s detected early. Common symptoms include neck stiffness, headaches, confusion, nausea, vomiting, high fever, and a rash.
Additionally, Dr. De Las Nueces wants clients to make use of shelter clinics found at most shelter sites should they believe themselves or others to be ill.