A disease more commonly associated with the trenches of the First World War, and sometimes found in refugee camps, has been detected in several Alberta patients who received organ transplants.

Bartonella quintana, an infection caused by body lice, has been detected in seven organ transplant recipients in Alberta since 2022, according to Dr. Dima Kabbani, a transplant infectious disease physician who treated the patients.

“It was quite alarming for us, especially since we know that this bacteria can cause a more serious type of infection, because sometimes it can affect your heart valve or some of the major organs,” Kabbani said.

“We were surprised to see this type of infection in Alberta.”

The disease, which appears as skin lesions, was transmitted to organ recipients from their donors, all of whom were homeless people and had themselves been infected.

“That indicates that the bacteria is actually around unhoused individuals. So that tells you a bigger public health problem,” Kabbani said.

“If these people had only had access to water to wash their clothes or take a shower, we should not have seen this type of infection among unhoused people in Alberta.”

Kabbani said he alerted Health Canada, which said it could not respond to CBC News in a timely manner. Kabbani recently wrote an article for the American Journal of Transplantation as a means of alerting other transplant programs in Canada and around the world.

As for the patients, Kabbani said all seven were treated with antibiotics and recovered.

WATCH | Patients contract diseases following organ transplantation:

Disease transmitted by body lice discovered in 7 organ transplant recipients in Alberta

Alberta health officials say seven people have been infected with Bartonella quintana, also known as “trench fever,” since 2022, all of them organ recipients and homeless. Experts are now screening unhoused donors and recipients to stop the spread.

Dr. Carl Boodman, infectious disease physician and microbiologist, who wrote a review article for the Open Forum Infectious Diseases on the Alberta cases, said the disease does not often appear in transplant situations.

“It’s new… It hasn’t really been described before. Or if it has been described, it has been described extremely rarely,” he said.

However, he stressed that organ transplants are crucial for patients.

“We do not intend for these cases to limit organ transplants. This is a service that saves the lives of many people,” he said.

“What we hope is that donors with risk factors for Bartonella quintana are recognized quickly so people know that recipients may be at increased risk.”

Organizations are not surprised

News of the situation comes as no surprise to Marliss Taylor, a registered nurse and director of Streetworks, a harm reduction program in Edmonton.

“When there aren’t a lot of shower spaces available, or the ability to get clean clothes, it can be very difficult to maintain your hygiene in any way,” she said .

A hygiene center in Edmonton with toilets and showers closed at the end of August.

“It’s the loss of another resource that people would use to be able to maintain their own cleanliness,” Taylor said.

Tricia Smith, executive director of Radius Community Health and Healing in Edmonton, said body lice have been found in homeless populations.

“Until there is a real concerted effort, a consistent effort at the population level, that’s what we’re going to continue to see,” she said.

New AHS Guidelines

Alberta Health Services did not make anyone available for an interview.

In a statement to CBC News, AHS said its donation and transplant programs prioritize the safety and well-being of donors and recipients.

“New guidelines now ensure that unhoused donors and their recipients are tested three, six and 12 months after transplant,” the statement said.

Kabbani said she thinks this scenario could become more common in the future.

“With the problem of drug overdoses in North America, we’re seeing a lot more donors die from overdoses and these individuals, because of their addiction, sometimes aren’t housed or don’t have stable housing, so they are in a more difficult situation at risk of being infected,” she said.