Infectious disease exposures and contact tracing in homeless shelters

J Health Care Poor Underserved. 2008 Nov;19(4):1163-7. doi: 10.1353/hpu.0.0070.


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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Canada
  • Communicable Disease Control
  • Communicable Diseases / epidemiology*
  • Contact Tracing / statistics & numerical data*
  • Disease Outbreaks
  • Female
  • Homeless Persons*
  • Humans
  • Male