Homeless shelters have been associated with TB outbreaks in the United States including Iowa. Homeless persons are included in the high-risk classification for developing TB disease by CDC as they suffer disproportionately from a variety of health problems, including TB. There is substantial potential for TB transmission in shelters, especially in the winter when they are likely to be more crowded and ventilation from the outside may be diminished.
Detecting, treating, and preventing TB in this special population benefits not only persons who are homeless, but society at large. The goal of prevention and control of TB among the homeless is difficult and challenging, but it can be achieved.
Shelter staff play an important role in communicable disease detection and prevention. Staff who screen guests for signs/symptoms of TB disease and follow “Cough Alert Policies” help to find active cases of TB and prevent the spread of TB to others. Observe shelter guests for signs of TB and refer individuals who are coughing for 3 weeks or more or who have other signs of TB to the local health department for evaluation.
The TB Control Program recommends Homeless Shelters in Iowa consider implementing the following screening and testing recommendations. These recommendations are adapted from Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Settings, 2005 MMWR December 30, 2005 / 54(RR17);1-141: