Bartonella quintana, or trench fever, is caused by a bacterial infection that resides in the feces of body lice. Severe cases can lead to potentially fatal infections of the heart valves. The disease is not reportable, so there is no data on its prevalence in the U.S., and diagnosis can be challenging due to the slow growth of the bacteria, making it frequently missed.
Organ transplant recipients are particularly at risk of severe cases if they receive a contaminated organ.
While the infection is not new, the CDC papers raise concerns about its impact on vulnerable communities. The report highlights five people in New York who experienced homelessness outside shelters and two kidney transplant recipients who received organs from a donor with a history of homelessness. Two of the infected individuals died, and the organ recipients experienced unusual symptoms.
The infection “is almost certainly underdiagnosed, under-recognized and undertreated, which then contributes to the potential for increased transmission,” Grace Marx, MD, an author on all three CDC papers and a medical epidemiologist for the agency based in Fort Collins, Colo., told the Post.
The CDC recommends that transplant facilities inquire about the housing status of organ donors and that physicians evaluate patients experiencing homelessness for B. quintana.
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