CDC Warning: Infections Spread Via Body Lice in Homeless Populations

According to a Nov. 20 article from The Washington Post, the CDC released three papers on a rare disease spread by body lice poses a danger to people experiencing homelessness and others who have received organ transplants from the infected.

The article said, “The bacterial infection, known as Bartonella quintana, or trench fever as it was called during World War I, lives in the feces of body lice and can cause skin lesions, fever and bone pain. However, severe cases can lead to a potentially fatal infection of the heart valves.”

Further, “The CDC cases included five people in New York who had experienced periods of homelessness outside of shelters, and two kidney transplant recipients who received their organs from the same deceased donor, a person with a history of homelessness. Two of the infected in New York died. A separate paper published recently described a cluster of six patients in Alberta who were infected in a span of less than two years, none fatally, after receiving organ transplants from people who had been homeless (a seventh patient was confirmed after the paper went to press).”

B. quintana is not a reportable disease, according to the article, and there is no data on many cases occur in the United States each year. The infection can be challenging to diagnose and is often missed because the bacteria grow slowly and take up to three weeks to reach detectable levels in routine blood tests. Because organ transplant recipients take medication to suppress their immune systems, they can suffer especially severe cases of B. quintana.

Grace E. Marx, an author on all three of the CDC papers and a medical epidemiologist for the center based in Fort Collins, Colo., said the CDC is recommending that transplant facilities ask about the housing status of organ donors and that doctors consider the possibility of B. quintana when evaluating patients who are homeless or have received an organ from a donor who has been homeless.