Bartonella quintana heart valve infection: a child in Northern Manitoba

What is it about?

Since a body-lice infestation causes itchiness, and the lice excrete Bartonella quintana in their feces, scratching one’s skin can lead to small abrasions that allow the bacterium to enter the body through tiny scrapes. It eventually hides within human red blood cells and can cause a bloodstream infection that may last for several months and can become fatal. The aforementioned 11-year-old required heart valve surgery, intensive care and months of antibiotics. Luckily, he survived, but Bartonella quintana endocarditis is associated with a mortality rate greater than 10 per cent, even with treatment.

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Photo by Yoann Boyer on Unsplash

Photo by Yoann Boyer on Unsplash

Why is it important?

Bartonella quintana is transmitted by body lice; this bacterium is notorious for causing “trench fever” among soldiers in World War I. Infection with Bartonella quintana is associated with extreme poverty, affecting those in cramped housing with limited access to water. Since WWI, outbreaks of Bartonella quintana have been reported among populations experiencing homelessness in various cities, including Marseilles, San Francisco, Baltimore and Winnipeg.In recent years, cases of Bartonella quintana endocarditis have been discovered in several reserves without access to running water. In 2015, a case was reported from a remote Manitoban reserve bordering Saskatchewan.2 That year, an individual from Nunavut died of Bartonella quintana endocarditis.3 From 2020 onwards, five additional cases were found in Manitoba and Alberta.3,4 Many other infections with Bartonella quintana remain undiagnosed and unreported because it is not on the list of reportable diseases in Canada. When water is scarce, it is prioritized for drinking and cooking. For many households without clean running water, regular showers, baths and laundry are simply not possible. Body lice infestation and Bartonella quintana infections are the result.

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