Asia
China
In 2011, there were approximately 2.41 million homeless adults and 179,000 homeless children living in the country. However, one publication estimated that there were one million homeless children in China in 2012.Housing in China is highly regulated by the Hukou system. This gives rise to a large number of migrant workers, numbering at 290.77 million in 2019. These migrant workers have rural Hukou, but they move to the cities in order to find better jobs, though due to their rural Hukou they are entitled to fewer privileges than those with urban Hukou. According to Huili et al., these migrant workers "live in overcrowded and unsanitary conditions" and are always at risk of displacement to make way for new real estate developments. In 2017, the government responded to a deadly fire in a crowded building in Beijing by cracking down on dense illegal shared accommodations and evicting the residents, leaving many migrant laborers homeless. This comes in the context of larger attempts by the government to limit the population increase in Beijing, often targeting migrant laborers. However, according to official government statistics, migrant workers in China have an average of 20.4 square metres (220 sq ft) of living space per capita, and the vast majority of migrant workers have basic living facilities such as heating, bathing, refrigerators, and washing machines. Several natural disasters have led to homelessness in China.
The initial fever is usually followed in a few days by a single, short rise but there may be many relapses between periods without fever. The most constant symptom is pain in the legs. Recovery takes a month or more. Lethal cases are rare, but in a few cases "the persistent fever might lead to heart failure". Aftereffects may include neurasthenia, cardiac disturbances and myalgia. Pathophysiology
Bartonella quintana is transmitted by contamination of a skin abrasion or louse-bite wound with the faeces of an infected body louse (Pediculus humanus corporis). There have also been reports of an infected louse bite passing on the infection. Diagnosis
Serological testing is typically used to obtain a definitive diagnosis. Most serological tests would succeed only after a certain period of time past the symptom onset (usually a week). The differential diagnosis list includes typhus, ehrlichiosis, leptospirosis, Lyme disease, and virus-caused exanthema (measles or rubella). Treatment
The treatment of trench fever can vary from case to case, as the human body has the ability to rid itself of the disease without medical intervention. Some patients will require treatment, and others will not. For those who do require treatment, the best treatment comes by way of doxycycline in combination with gentamicin. Chloramphenicol is an alternative medication recommended under circumstances that render use of tetracycline derivates undesirable, such as severe liver disease, kidney dysfunction, in children under nine years and in pregnant women. The medication is administered for seven to ten days.