Rat-borne disease of 'high risk' to homeless identified in Boston

Oct. 17—The Boston Public Health Commission is warning of a dangerous rat-borne disease that puts the homeless at "high risk" as the rodent population and encampments boom side by side in Mass and Cass.

"The Boston Public Health Commission is investigating a case of human leptospirosis resulting in hospitalization," the BPHC began in memos sent to the city's first responders and to clinicians in Boston.

Leptospirosis is a potentially nasty disease spread by the urine of infected animal — often rats or mice. It's a bacterial infection that's normally rare in the U.S., per the BPHC's fact sheet.

The potential symptoms read like a what's what of what you don't want: "fever, headache, myalgias, conjunctival suffusion, nausea, vomiting, diarrhea, abdominal pain, cough, and/or rash. Severe symptoms can include jaundice, renal failure, hemorrhage (especially pulmonary), aseptic meningitis, cardiac arrhythmias, pulmonary insufficiency, and hemodynamic collapse ... even death."

The BPHC says it usually is mild, but sometimes it escalates in two phases — first with the flu-like symptoms, and then the severe ones often develop a week later, sometimes after the person appears to have recovered.

The BPHC is telling clinicians to be on the lookout for this disease. WCVB first reported that the city was dealing with a case of leptospirosis.

"Within the context of rising homelessness associated with the COVID-19 pandemic, and increasing numbers of rodents, people experiencing homelessness and/or residing in congregate settings should also be considered at high risk," the BPHC wrote in a memo to clinical providers in the city. Asked whether the identified case was in the Mass and Cass area, the BPHC said, "BPHC cannot disclose any information regarding the residential address of any particular case, though the risk for exposure is heightened in unsheltered living conditions."

This is one of various illnesses called "reportable diseases" — ones that clinicians have to notify the health department of. The BPHC is telling people to, "Collect history of housing status, including shelter setting or encampments" from people who present with the disease.

The BPHC is also warning first responders to be aware of it and to watch for symptoms.

Michael MacNeil, of the EMS workers union, said the city hadn't done enough to head this off.

"The city has turned a blind eye to the deplorable conditions at Mass and Cass and are treating its first responders like canaries in coal mines."

This comes as conditions deteriorate in the vicinity of the South End's Newmarket area, known as Mass and Cass or Methadone Mile, where there remains essentially a large tent city of people living on the street, often using or selling drugs. Locals say the rat population — periodically a problem in various neighborhoods of Boston — particularly has boomed there lately.

Just earlier this week, the Herald reported that city workers at the BPHC-run shelters on the Mile were alarmed by the filthy conditions in the area, and that several had taken sick — to the point at which they required hospitalization. A worker who'd been sick told the Herald he'd seen a diseased-looking rat trundle over people on the ground.

The union representing the workers made a push after that for the city to improve conditions on the Mile and specifically around the places where its workers operate.

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