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- Page navigation anchor for RE: Lousy living conditions in Canadian cities.RE: Lousy living conditions in Canadian cities.
The reported case series of Bartonella quintana endocarditis provided a fascinating perspective on the modern presentation of a disease usually associated with World War I. A key point that warrants emphasis is that this disease is among the most easily preventable of infections. Persistence of the vector, Pediculus humanus corporis, the human body louse, which incidentally can also transmit two other life threatening pathogens, requires extreme conditions of squalor and privation. These conditions are typically combined with cold temperatures which necessitate continuous wearing of heavy clothing, and lack of access to even the most basic of hygiene and washing facilities. Such extreme conditions are characteristic of the trenches of World War I or more recently, some of the most awful refugee camps. This report illustrates how we are now replicating these conditions among unstably housed people in Canada who don’t have access to a safe place where they can bathe and clean their clothes in winter. This disease cluster should prompt us to ask how it is that the lives of some Canadians have so much in common with those of refugees or soldiers in the hellholes of WWI.
Competing Interests: None declared.References
- Carl Boodman, Terence Wuerz, Philippe Lagacé-Wiens. Endocarditis due to Bartonella quintana, the etiological agent of trench fever. CMAJ 2020;192:E1723-E1726.
- Page navigation anchor for RE: Historical Context of Bartonella quintana in CanadaRE: Historical Context of Bartonella quintana in Canada
The presence of Bartonella quintana infections in Canada has long been known but infrequently published. Historically, anecdotes were occasionally discussed among bacteriologists who were working in Canada’s provincial laboratories and who often congregated at the annual national Conjoint Meeting on Infectious Diseases. The bacteria were often unidentifiable blood culture isolates from peripheral laboratories and which in the past were labelled by names Rickettsia quintana or Rochalimaea quintana at these reference laboratories. The Vancouver-based BCCDC had experience with such isolates.(1) A pediatric infection with an unusual presentation from north Vancouver Island was also cited.(2) Mateen and colleagues found B. quintana causing bacillary angiomatosis and complicating an HIV infection in Saskatchewan.(3) Molecular diagnostics were used to establish B. quintana as a likely cause of infection among family members residing in the Lanaudière region, Quebec.(4)
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Most intriguing however was the mystery illness investigated by Dr. James A. Baker in the 1940s.(5) Dr. Baker was then stationed at the War Disease Control Station on Grosse Isle, Quebec, an island downstream on the St. Lawrence River but not overly far from the upstream inland Lanaudière region. As a captain in the Veterinary Corps of the US Army, he and others conducted conjoint Canadian-American studies. During Dr. Baker’s stay, his research led to the finding of a potentially novel rickettsial bacterium...Competing Interests: None declared.References
- 1. Cimolai N, Cimolai T. Infections in the natural environment of British Columbia, Canada. J Infect Public Health 2008;1:11-26.
- 2. Cimolai N, Roland E. Is Bartonella quintana endemic to British Columbia? Clin Invest Med 1999;22(4 Suppl.):S33.
- 3. Mateen FJ, Newstead JC, McClean KL. Bacillary angiomatosis in an HIV-positive man with multiple risk factors: a clinical and epidemiological puzzle. Can J Infect Dis Med Microbiol 2005;16(4):249-52.
- 4. Breitschwerdt EB, Maggi RG, Quach C, Bradley JM. Bartonella spp. bloodstream infection in a Canadian family. Vector Borne Zoonotic Dis 2019;19(4):234-41.
- 5. Weiss E, Dasch GA, Woodman DR, Williams JC. Vole agent identified as a strain of the Trench Fever rickettsia, Rochalimaea quintana. Infect Immun 1978;19(3):1013-20.