A disease that afflicted soldiers mired in trench warfare during World War I has been detected among some homeless people in Canada, according to reports.
A study published Monday in the Canadian Medical Association Journal found that trench fever — a potentially fatal bacterial disease transmitted by body lice — was present in some of the country’s urban, homeless populations, CTV News reported.
The illness, which is caused by the bacteria Bartonella quintana, killed millions of troops during World War I from 1914 to 1918, when it was first described. Its symptoms include fever, muscle aches, headaches, rashes and pain in the shins.
“Our public health message is that this disease is present in Canada and that people and physicians aren’t always aware,” University of Manitoba infectious disease expert Dr. Carl Boodman said in a press release.
“It’s associated with homelessness and homeless shelters, and physicians should consider B. quintana infection in people who are unwell and have a history of body lice infestation,” Boodman added.
Trench fever can lead to a potentially fatal heart infection known as endocarditis, according to the news outlet, which added that molecular testing and consultation with infectious disease experts is often needed for diagnosis.
According to the study, a 48-year-old man visited a hospital in Manitoba with chest pain and shortness of breath had also sought care multiple times in the past 18 months for “episodes of chest pain and body lice infestation.”
Four days after being admitted, the man underwent a mitral and aortic valve replacement operation for “severe valvular damage” to his heart from the age-old trench ailment.
The man was HIV-positive and a former drug user, but had been taking his antiretroviral medication, the Guardian reported. He was given antibiotics for his Bartonella Quintana infection.
Three other patients were identified in Winnipeg over a six-month period, all of whom had accessed the same homeless shelter, according to the study, which notes that there have only been these four cases of trench fever detected in Canada in the past two decades.
But researchers said they expect that there are more cases in Canada’s homeless populations as the disease “likely remains underdiagnosed.”
“Clinicians should consider Bartonella serology, echocardiography and infectious disease consultation when caring for individuals who present unwell with a history of body lice infestation,” the study said.
Jon Sparkes, chief executive at the homeless charity Crisis, told the Guardian that homelessness affects people’s mental and physical health.
“Preventative and specialist health care that is truly accessible to those facing homelessness is vital and will in turn prevent disease spread and reduce reliance on emergency health care services,” he told the outlet.
“We all deserve the opportunity to build a healthy life for ourselves, so it is only right we make sure this is a reality for people facing homelessness too,” Sparkes added.
