Rare illness associated with World War I soldiers detected among homeless Winipegers

The disease is transmitted through the feces of body lice, which can remain on clothing, causing itching and causing people to scratch and scratch the skin, Boodman said.

This is one of the obvious signs of a misunderstood infection and can also cause fever, shin pain, and a fatal heart infection called endocarditis.

Boodman, who also trains in medical microbiology at the University of Manitoba, said only four cases were known to have occurred in Canada since the mid-1990s.

However, doctors are unlikely to know what to look for, and therefore do not order a specific laboratory test to detect the condition-related bacterium Bartonella Quintana, which was first associated with the condition a century ago. , The case may not be diagnosed.

Boodman, the lead author of an article highlighting Trench Fever in the Monday edition of the Canadian Medical Association Journal, knows that neglected and preventable diseases of poverty affect people who are homeless and have little access to health care. Said.

“This is a disease associated with wartime conditions and refugee camps and has been found in Canada. Without this degree of poverty in Canada, the disease would not have been possible,” he said.

People living in shelters may share clothing that allows dry feces of body lice to survive for weeks, says Boodman, washing facilities and showers to prevent the spread of common illnesses among people. And those who are undervalued across Canada, adding that there is a need for public health for access to affordable homes.

You know nothing about it for 20 years or so, and you have this series of incidents-Dr. Karl Budman

He treated the first case of trench fever in February when the patient visited Winnipeg’s emergency department.

A 48-year-old man with shortness of breath and chest pain repeatedly sought medical care in the first half of the previous year due to episodes of chest pain and body lice epidemics, Boodman said of a patient who spent a month in the ICU. At the hospital after cardiac surgery for endocarditis. He then recovered.

Approximately two weeks after starting treatment for that patient, Boodman was very “confused” because he saw a second patient who looked like a trench fever and repeated the lab test twice before confirming the diagnosis. did.

About a month later, he treated a third patient with the same illness at another hospital before a colleague mentioned a mysterious case involving a man with endocarditis. Laboratory tests confirmed that he also had trench fever.

“I don’t know anything about it for about 20 years, and then you have this series of cases,” Boodman said, and some patients count the bacteria associated with body lice in their bloodstream. It can be serious, having months and may be asymptomatic due to illness, and requires surgery to replace the heart valves.

A combination of antibiotics is often prescribed, but its prevalence is unknown, as the treatment of the disease is controversial and has not been reported to public health authorities in Canada and the United States, Boodman said. ..

A small study from cases in southern France and in US cities, including Seattle and San Francisco, estimates that up to 20 percent of homeless people with body lice may have been exposed to trench fever-causing bacteria. I will. ..

Dr. Stephen Juan, chair of the Homeless, Housing, and Health Research Committee at St. Michael’s Hospital and the University of Toronto, needs to be aware of rare but potentially fatal trench fever, including skin infections. Other conditions were also mentioned. , Respiratory illness, uncontrolled diabetes, and high blood pressure are common among people who are short of housing.

Fans treat homeless people in Toronto shelters and camps as members of a group called Inner City Health Associates, Canada’s largest organization, with 100 doctors and nurses working together, including a rest center. We provide care to the basement in the location. And the hotel.

The aim is to provide better primary care to those who are also experiencing many mental health and addiction problems, especially as more families and older people are becoming homeless, adding safer housing. That is the key to better health, he said.

“Without that stability, it’s very difficult to deal with the acute or chronic conditions they’re dealing with. We need to invest in building really affordable homes. If you have to pay the cost of health effects. That. “