Louseborne Bartonella quintana infections in the United States occur almost exclusively among persons experiencing homelessness because of inadequate access to hygiene resources. Homelessness is increasing, and persons experiencing homelessness are often organ donors despite barriers to receiving donated organs themselves. Recent reports have documented B. quintana transmission via organs transplanted from donors who had recently experienced homelessness. Those reports demonstrate the threat of severe bartonellosis in immunosuppressed organ transplant recipients after donor-derived B. quintana infection. Addressing the root causes of B. quintana transmission could improve the quality of life for persons experiencing homelessness and simultaneously mitigate risk for donor-derived B. quintana transmission. Interventions include improved access to housing, consistent access to hot water for showers and laundry, early treatment of body lice infestation and B. quintana infection, and B. quintana testing and prophylactic treatment of recipients of organs from donors who have experienced risk factors for B. quintana, including homelessness.

在美国，虱子传播五日热巴尔通体感染几乎只发生在由于卫生资源不足而无家可归的人中。无家可归者正在增加，无家可归者通常是器官捐献者，尽管他们自己在接受捐献的器官方面存在障碍。最近的报告记录了 B. quintana 通过移植自最近无家可归的捐献者的器官传播。这些报告表明，在供体来源的五日热双歧杆菌感染后，免疫抑制的器官移植受者存在严重巴尔通体病的威胁。解决五日热芽孢杆菌传播的根本原因可以改善无家可归者的生活质量，同时降低供体来源的五日热芽孢杆菌传播的风险。干预措施包括改善住房可及性，持续获得用于淋浴和洗衣的热水，早期治疗体虱感染和五日热双歧杆菌感染，以及对经历过五日热双歧杆菌风险因素（包括无家可归）的供体器官接受者的器官进行检测和预防性治疗。