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Overview of Typhus, Typhoid Fever, Tuberculosis and Plague

After 22 years as an RN, I now write about medical issues and new medical advances. Diet, exercise, treatment, and lifestyle are important.


Disease Rampant on CA Streets

In Los Angeles (there are 39,000 estimated homeless), and in San Francisco there are 8,011 living in shelters, with 880,00 people sleeping on the streets, sometimes in tents, in cars or even just on the sidewalk. This is a problem that has evolved over time with little effective intervention by the government. There has been a large amount of money spent, but officials are far from solving the problem.

Some of the problems include urine, feces and used needles on the street, along with rats. The rats are a problem because they often have fleas that carry diseases. In addition, cats and feral cats are abundant. Animals of any kind can prey on the rats who may be infected with the plague or they may have plague-infected fleas.

This article is not to blame the homeless for their problems. This article is to talk about some dangerous diseases that have appeared due to the overcrowding on the streets.

Homeless Cat



Typhus killed 17,000 Spanish soldiers in 1489. Typhus (typhus fever) is actually three types of infectious diseases that include: epidemic typhus (due to Rickettsia prowazekii) spread by body lice and is rare in U.S. Scrub typhus (Orientia tsutsugamushi spread by chiggers) and murine typhus (Rickettsia typhi) spread by fleas, which is rarely fatal, but it is in Los Angeles.

Scrub typhus still occurs in Southeast Asia, and murine typhus happens in tropical and subtropical areas in the world. The flea-borne marine typhus is found in Los Angeles County each year, according to Muntu Davis, MD, MPH, a Los Angeles County Health official There is an increase in the number of people with marine typhus over the past couple of years in San Francisco as well.

There is no vaccine that prevents this disease, and it is caused by person-to-person contact if one person is infected with body lice. The fleas, ticks, or lice get into the bloodstream., which causes the illness. Symptoms typically begin at two weeks after exposure and include sudden onset of a high fever, rash, nausea, vomiting and flu-like symptoms. The antibiotic doxycycline treats epidemic typhus.

Trash pickup and rodent control are essential to prevent this disease. Pet owners are also encouraged to use flea control. There were approximately 60 cases annually in the past, and now the number has risen to 1,000 cases since 2017. Untreated cases can be fatal, especially for people over the age of 60.

Typhoid Fever

Typhoid fever outbreaks are caused by salmonella typhi. This disease is not the same thing as typhus. Recently, an LA police officer and two more from his workplace were diagnosed with this disease. This acute illness is caused by bacteria that is found in water or food of human carriers, then it is spread to other people. It is found in the liver, bone marrow, and the spleen as it is carried by white blood cells, which multiply and reenter the bloodstream. After approximately two weeks they can be found in the stool and urine.

Symptoms of this disease include:

  • Loss of appetite
  • High fever
  • Lethargy
  • Diarrhea
  • Generalized aches and pains
  • Abdominal pain

Antibiotics are given to treat the Salmonella bacteria. The fertility rate is 20% without antibiotics. Antibiotics will limit the disease to a 7-10 day period, but there is a 1-2% death rate. About 3%-5% of people become chronically ill and are on antibiotics for their lifetime, while others must have their gallbladder removed.

Mary Mallon was known as “Typhoid Mary”. She was an asymptomatic carrier of this disease, who was born in Cookstown, Ireland in 1869. As a cook for affluent families, she is believed to have infected 51 people and 3 died. Authorities forcibly isolated for three decades of her life.

Typhoid Fever

Hepatitis A, B and C

Hepatitis A is also a problem throughout California. A state of emergency was called under Governor Jerry Brown. Hepatitis A rose in huge numbers between 2016-2018 in the homeless population. There is a vaccine available for Hepatitis A, which would help limit any outbreak. There is no specific treatment for this disease, so only symptoms warrant medical treatment.

Symptoms of hepatitis A include:

  • Fatigue
  • Sudden nausea and vomiting
  • Abdominal pain or discomfort, especially on the upper right side beneath your lower ribs (by your liver)
  • Clay-colored bowel movements
  • Loss of appetite
  • Low-grade fever
  • Dark urine
  • Joint pain
  • Yellowing of the skin and the whites of your eyes (jaundice)
  • Intense itching

Hepatitis C is spread from a person who is infected to another person through needles, syringes or other items to inject drugs. The symptoms for this disease are similar to Hepatitis A. Chronic hepatitis B is also a problem in CA, and unfortunately, it may spread.

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Hepatitis C can be acute or chronic. It attacks the liver and can cause liver cancer. Acute infection often leads to chronic infection. Hepatitis C is an acute infection that attacks the liver. There is no vaccine for this Hepatitis, but there are treatments. A person is considered cured if there is no virus left in their blood.

Kassy Dillon on San Francisco Homeless Crisis and Opioid Epidemic

Bubonic Plague

Physicians have warned that bubonic plague will occur if conditions are not cleaned up in Los Angeles. Bubonic plague is a curse from the middle ages that killed thousands. Worldwide typhoid fever has affected more than 21 million people annually over many years, with about 200,000 people dying from the disease annually. Less than 400 cases have been reported in the U.S. annually in recent years. Fears concerning bubonic plague in CA have grown due to the uptick in typhus cases.

Body Louse


Other Illness

There has been an 88% increase of syphilis in San Francisco between 2017-2018. Measles has also been seen, but a well-tested vaccine can prevent this virus. There are reported cases of illness caused by staph and E coli that is found in food.

Officials are concerned about Ebola or Marburg virus disease outbreaks, as there is an outbreak in the Congo, so international travelers could potentially infect a homeless person, and these diseases can spread easily through a crowd of homeless people.

In Summary

Unsanitary conditions and rats are certainly a concern for the homeless areas in CA. Additional temporary housing, portable toilets, food and treatment for diseases, alcoholism, drug abuse, and mental illness may help. Government officials have to change the dynamics in a dramatic fashion if they want to get ahead of various disease epidemic possibilities.

Share any ideas in the comments if you have an idea of ways to treat this growing problem.

Diseases in Homeless Population


This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

© 2019 Pamela Oglesby


Pamela Oglesby (author) from Sunny Florida on July 18, 2020:

Hi Rajan,

I fully agree with you. There are many homeless in the U.S and I think more needs to be done. Thanks so much for your comments.

Rajan Singh Jolly from From Mumbai, presently in Jalandhar, INDIA. on July 17, 2020:

Dirt and crowd is one reason for a host of epidemics. It must be ensured that there are facilities for the homeless so that unsanitary conditions can be prevented.

Pamela Oglesby (author) from Sunny Florida on February 23, 2020:

Hi Peggy, These diseases are very concerning. I agree there has to be a way to solve this problem. Thank you for your comments.

Peggy Woods from Houston, Texas on February 22, 2020:

This is very alarming that diseases that used to be a thing of the past might be emerging again. The homeless situation is so sad, particularly in a country like ours. It would seem that if enough brainpower and energy were expended into solving it, it could be accomplished. After all, we put a man on the moon!

Pamela Oglesby (author) from Sunny Florida on September 10, 2019:

Hi Dianna, I have read that the government is providing health cre for some of these homeless but how many I don't know. I agree the cost of medical care is very expensive. I wish some of these politicians that talk about getting prescriptions reduced would do something besides talk. I appreciate your comments.

Dianna Mendez on September 09, 2019:

I sincerely hope and pray these diseases are a thing of the past. The cost of medical care is quite expensive for people and the homeless would be most likely be denied access to good care.

Pamela Oglesby (author) from Sunny Florida on September 06, 2019:

Hi Genna, I could not agree with you more. We do need to do something for these homeless and with compassion. We don't know why they are homeless, but authorites need to begin solving the problems. If they need drug rehab or if they just a place to live with a job that meets their needs, we must solve this problem. I am concerned about these diseases becoming more wide-spread. Thank you so much for your comments.

Pamela Oglesby (author) from Sunny Florida on September 05, 2019:

Hi Eric. It would probably be more helpful to give food as cash might be used for drugs. Thanks for your comments, Eric.

Pamela Oglesby (author) from Sunny Florida on September 05, 2019:

Hi RTalloni, I can't imagine what the politicians are waiting for, so maybe you are right. They will feel more justified. I am concerned about some plague affecting a larger number of people. I appreciate your comments.

Eric Dierker from Spring Valley, CA. U.S.A. on September 05, 2019:

Reread this. So you can get a bunch of "Wipees" at our 99cent store for just like 2 bucks. Now how easy is that? Then you go on down to the recycle center and toss them around. (here recycling is a major homeless enterprise)

Now I could do like my wife and give out some cash to the panhandlers --- but.

RTalloni on September 05, 2019:

Thank you for highlighting these concerning issues. It's horrible to think what will happen when the likely scenario of just one of these diseases reaching plague status occurs. It almost seems that the politicians with power to legally move these people from the streets in LA are just waiting on something to break in the situation.

Pamela Oglesby (author) from Sunny Florida on September 05, 2019:

Hi Maria, Homeless people are sure a big problem in CA. I don't have the answers, but the problems are growing. Maybe if CA offered housing with some conditions on the homeless person, maybe they would respond. I am not sure what to do about those addicted to drugs.

I always appreciate your kind comments, Maria. Love, Pam

Pamela Oglesby (author) from Sunny Florida on September 05, 2019:

Hi Mel, It is aa big problem, and I do not know the solution. Until the CA government decides to be more active nothing will change. Thank you for your comments.

Maria Jordan from Jeffersonville PA on September 04, 2019:

Dear Pam,

The scope of these issues is so far reaching. You have done a masterful job of focusing on the outbreaks in CA.

Having worked with the homeless population in Philadelphia for a few years, I saw similar heartbreaking conditions. I worked with some gracious and beautiful people who had encountered life-altering circumstances leaving them homeless through no fault of their own.

I also wish I had some answers to this multifaceted issue. Raising awareness as you are is a herculean step to me. Thank you so much.



Mel Carriere from Snowbound and down in Northern Colorado on September 04, 2019:

There are no easy answers to this issue, but at some point society is going to have to get tough and crack down. I think we are reaching the point where even progressives are feeling less compassion, and more indignation. Extremely informative article.

Genna East from Massachusetts, USA on September 02, 2019:

Every time we read the news, we often find that the CDC has alarming warnings and updates on a variety diseases (plus warnings of disease carrying vectors, birds, rodents, etc.) that we face. Irrational fear of vaccinations pose another threat.

The diseases on the streets of CA are becoming more synonymous with third-world countries, and the plagues that threatened us so many years ago.

The homeless problem is our problem, and we must solve this, together, and with compassion. Thank you for this interesting article, Pamela.

Robert Sacchi on August 30, 2019:

Yes, it is sad and dangerous.

Pamela Oglesby (author) from Sunny Florida on August 30, 2019:

Hi again Robert, You are exactly right. There are man people who are afraid of vaccines and think they might cause autism, but there is absolutely no proof of that. For instance, the measles, mumps and rubella vaccine has been studied numerous times and there is no connection to autism. The people who have not been vaccinated and live in CA may be at risk for several different diseases. It is a sad situation.

Robert Sacchi on August 29, 2019:

Of concern domestically is that these diseases might spread. There also seems to be an anti-vaccination movement in America. Could this be a perfect storm for diseases.

Pamela Oglesby (author) from Sunny Florida on August 29, 2019:

Hi Robert, Your comments are so true, and traveling to those areas is a risk. Thanks so much for your comments.

Pamela Oglesby (author) from Sunny Florida on August 29, 2019:

Hi Yves, I did not remember the politics affected CA in the Reagan years, so thanks for that information. I did want to kept this article more on the risk on diseases right now, but the political landscape is surely a factor. I think it is a scary time for anyone who lives in that area and Your are right, this is not okay. I appreciate your comments.

Robert Sacchi on August 28, 2019:

It seems these are good places to avoid and leave. It's good that you posted this. People from other countries might not be aware of the gravity of the situation in these cities.

savvydating on August 28, 2019:

Right. That was Reagan's reason for signing the as not to force institutionalization. However, Reagan reversed his cuts and increased spending on the Dept. of Mental Hygiene by $28 million. By 1973, the no. of patients in Calif. mental hospitals fell to 7,000. That's pretty good!

Afterward, Carter did something else which may have messed things up again.

Anyway, I veered off into politics and you allowed it. Thank you for your patience, Pamela. I had grown up in California. I hate that citizens are being infected with diseases there for no good reason. Our men in blue are suffering. So many people are getting sick. That is not okay!!

Pamela Oglesby (author) from Sunny Florida on August 28, 2019:

Hi Vivian, I agree that their priorities are wrong. It seems most of the homeless are American citizens, and they deserve some help to rebuild their lives. The threat of these diseases is real, and some policmen have become ill already. Typhus has made a come-back, unfortunately. I appreciate your comments.

Pamela Oglesby (author) from Sunny Florida on August 28, 2019:

Hi Yves, Gavin Newsom seems to be more interested in other things. San Francisco is more worried about banning plastic water bottles that helping the homeless. We hear so much about doing things for the illegal immigrants, but we need to help the homeless.

I don't necessarily thing they should be institutionalized against their will unless they are a danger to themselves or others. I do think they should all receive medical care if they need it. I know drug addiction is a problem, but I don't think all the homless are addicted to drugs.

I really appreciate your comments, and you gave me some things to think about. I can see why Newsim's ratings are falling.

Vivian Coblentz on August 28, 2019:


This is alarming because we've been so successful in wiping out disease, only for some to make a significant comeback and be a real threat to our society.

Nancy Pelosi and other Democrats are in charge of the areas in California you mentioned, and what we're seeing is the typical effects of decades of liberal control of big cities. If the Dems would focus on making lives better for the people in their jurisdictions instead of making their sole platform "Attack Trump," maybe they could actually make some headway in solving this serious problem.

savvydating on August 27, 2019:

A note-worthy, excellent article. One that is deserving of everyone's attention.

I do not blame the homeless, but I do blame the good-for-nothing Governor, Gavin Newsom, who is as useless and phony as a snake charmer, for encouraging this mess. Sorry to inform your readers, but only the most liberal states have this disease/epidemic problem.

That being said, I do believe the homeless should be kept safe, in a medical facility. They must be cared for properly and respectfully. I was not happy when Reagan let them loose decades ago. To be fair, in 1967, Reagan signed the Lanterman-Petris-Short Act to end the practice of institutionalizing patients against their will.

On the other hand, the homeless tend to congregate in warm climates cities. But not all warm climate cities have these problems.

The problems in Los Angeles and San Francisco are not likely to be resolved anytime soon. Gavin Newsom turns a blind eye to the real problems in California. His ratings are falling just as fast as Jerry Browns had.

Pamela Oglesby (author) from Sunny Florida on August 27, 2019:

Hi John, I couldn't agree with you more. This problems seems to be out of hand already, but if they would at least begin taking some effective steps to get people off the streets it would help. Thanks so much for your comments John. They are always appreciated.

John Hansen from Australia (Gondwana Land) on August 27, 2019:

Wow, Pamela, this is quite a disturbing situation. A solution needs to be found sooner than later before the situation escalates beyond control and there is a renewed outbreak of the plague. thanks for sharing.

Pamela Oglesby (author) from Sunny Florida on August 27, 2019:

Hi Ms Dora, I am sure the state must find this situation difficult, and this problem has grown so much this year. The diseases are a reason for concern. I appreciate your comments. Blessings to you.

Dora Weithers from The Caribbean on August 26, 2019:

This is a scary situation. Seems like homelessness could be one step away from loss of life. The state government must be finding it very hard to deal with. Thanks for making us aware.

Pamela Oglesby (author) from Sunny Florida on August 26, 2019:

H i Ruby, It is a horrible thing, and I wonder if some people cannot see another path forward. Do they want to live on the streets? I hope now.

I agree it should not be happening here, yet here it is. I wonder if it is drug addition, PTSD or is it just hopelessess? I sure hope we see some solutions in the near future. I certainly appreciate your comments.

Ruby Jean Richert from Southern Illinois on August 26, 2019:

In a land like America, there should be no homeless, oh, I know some people are lazy, but not thousands. This is a wakeup piece. I am ashamed this is happening. Well researched. Thanks for sharing.

Pamela Oglesby (author) from Sunny Florida on August 26, 2019:

Hi Linda, This problem definitely is now reaching he general population. It is frightening and I see no solutions right now. Twish there was an answer too. Thank you for your nice comments about this article, Lina.

Linda Lum from Washington State, USA on August 26, 2019:

Pamela, this is really well written, and frightening. Homelessness is a major issue in the Pacific Northwest (where I live). We have a mild climate, pot is legal, and are a sanctuary state with lots of (well-publicized) free handouts. Needles and human waste are not only a danger to the people living on the streets and in the parks but to the general population as well. I wish there was an answer.

Pamela Oglesby (author) from Sunny Florida on August 25, 2019:

Hi Linda, I could not agree with you more. The officials need to try something and at least make a better effort. I appreciate your comments.

Linda Crampton from British Columbia, Canada on August 25, 2019:

Homelessness is a serious problem that needs to be solved. People need help. Thanks for sharing the information about the diseases, Pamela.

Pamela Oglesby (author) from Sunny Florida on August 25, 2019:

Hi Flourish, I absolutely agree that vaccines are sometimes very important. I hope we don't come to a concern that epidemic diseases become a problem throughout our country, and I hope the governmental officials will come up with some solutions, They have just waited so long to begin.

FlourishAnyway from USA on August 25, 2019:

I had to get a typhoid vaccine before going to Peru and when I got there I understood why. This was a well written article.

Pamela Oglesby (author) from Sunny Florida on August 25, 2019:

Eric, I think the higher temperatures are like a petri dish to grow bacteria and viruses, so you are right on. If everyone does a little something the way you do it would help homeless people. I appreciate your comments my friend.

Pamela Oglesby (author) from Sunny Florida on August 25, 2019:

Hi Bill, I do not have the answers either, but something does need to be done. The diseases are a real scare for the future. I am glad you found the article helpful, and your comments are appreciated.

Pamela Oglesby (author) from Sunny Florida on August 25, 2019:

Hi Pop, I don't know why officials do not seem to be dealing with this problem in a better fashion. Diseases may be widespread in more areas in the future if something is not done. Thanks for your comments.

Eric Dierker from Spring Valley, CA. U.S.A. on August 25, 2019:

Pamela I was thinking on this of course and it hit me that our climate also is perfect for disease. Only five bucks but two blankets and 3 gallons of water and I did it without my boy.

Today it is 100+ we need to up the ante as some will get sick without a disease.

Pamela Oglesby (author) from Sunny Florida on August 25, 2019:

Hi Bill, I think you are right and if this someless problem is not dealt with we may be looking at new diseases advancing through out country. We all are concerned, but it seems solutions are scarce. I appreciate your comments.

Pamela Oglesby (author) from Sunny Florida on August 25, 2019:

Hi Linda, I don't know why they haven't tackled this problem before now. It is obviously a huge problem, and we have to be concerned about the spread of these awful diseases. Thanks for stopping by and commenting.

Pamela Oglesby (author) from Sunny Florida on August 25, 2019:

Hi Eric, It is nice that you did something to help, but I don't think anyone really knows how to solve this problem. It is a problem in many areas with a good climate as it makes living on the street more tolerable. I appreciate your comments

Pamela Oglesby (author) from Sunny Florida on August 25, 2019:

Hi Lorna, I think drugs are certainly a major factor, but it may not be the only factor. I listened to one of the homeless men say he has lived on the street for 15 years, and he did not say anything about wanting help changing his life. I agree that treatment for drug addiction is essential although you cannot make someone quit if they don't want to quit.

There are NA and AA programs that do not cost a dime. I wonder if PTSD is also a factor for vets.

I very much appreciate your generous comments.

Bill De Giulio from Massachusetts on August 25, 2019:

This is quite alarming that the homeless, who are already in need assistance, now have to worry about these diseases that sound like we are living in the Middle Ages. I certainly don’t have the answers, but it would seem that more could be done to address this problem. Thank you for the education, Pam.

breakfastpop on August 25, 2019:

I can't understand why cities like LA are turning a blind eye and a deaf ear to this problem. The possibility of plague is very, very real.

Bill Holland from Olympia, WA on August 25, 2019:

Our Seattle news station did a special report on homelessness in L.A.....unbelievable that in 2019 we are talking about The Plague in an American city....and soon other major cities will be facing this.....anyway,good report, my friend.

Linda Chechar from Arizona on August 25, 2019:

I just don't get it! The California state and local governments seem to ignore the huge homeless populations that are spreading epidemic diseases. I assume it will eventually become widespread throughout the western states.

Eric Dierker from Spring Valley, CA. U.S.A. on August 25, 2019:

So interesting.

In our place here in Southern Cal. We used to hand out stuff like blankets and water. So sad that now we just leave them to pick up. We have canyons where they live. But we cannot do garbage pick up anymore. They have to come in and spray first.

It is a problem here.

Lorna Lamon on August 25, 2019:

Your articles highlights the tragedy and reality of homelessness, not to mention the consequences if something isn't done. After listening to the video the problem seems to stem from drug use, however, I feel if you want to tackle drugs then you need to get to the core of the problem. More drug rehab clinics would help to tackle the drug issue, however, unless it's combined with a follow-up treatment plan, most of these people will end up back on the streets;so specialist accommodation to support these people might also help. With such high numbers these diseases could spread, with tragic consequences. Your article is detailed and informative - sensitively done Pamela.

Pamela Oglesby (author) from Sunny Florida on August 25, 2019:

Hi Liz, I am sorry to hear that the UK is seeing more measles. The vaccine to prevent this disease has probably had more research than any other vaccine and there are many causes for autism, and the vaccine is not one of them.

Thank you so much for your comments that let us look at a disease outside of the U.S. I think the disease is spread as people travel to other countries.

Pamela Oglesby (author) from Sunny Florida on August 25, 2019:

Hi Erin, Thank you for reading and commenting.

Liz Westwood from UK on August 25, 2019:

This is a well-presented anx informative article. It is very worrying to see diseases becoming widespread again. In the UK we have just lost our measles free status due to cases once again appearing in the UK. Rumours and bad press about unproven links of the vaccine with autism discouraged some parents from getting children vaccinated. This combined with ease of travel to and from other countries has seen cases of measles rise in the UK.

erinshelby from United States on August 25, 2019:

Good overview of these medical conditions.

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