"trench fever" among homeless in SF, Seattle
Tom Boland (wgcp@earthlink.net)
Fri, 2 Jan 1998 03:53:13 -0800 (PST)
FWD: Found using search-word "homeless" at: http://www.nando.net/search/
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TRENCH FEVER OF WW1 FLARES AMONG THE HOMELESS
SAN FRANCISCO (December 29, 1997 12:18 p.m. EST
http://www.nando.net) - The infamous "trench fever" of World War I
hasn't disappeared, it's just moved to new trenches. In San Francisco,
among the homeless AIDS patients who live in urban streets and
alleys, the affliction has found new victims.
The disease, called bacillary angiomatosis, preys on those with weak
immune systems. While curable with common antibiotics, the disease
often goes undiagnosed.
Its comeback was discovered by a UC-San Francisco research team
led by microbiologist Dr. Jane Koehler, who published her findings in
the latest issue of the New England Journal of Medicine.
During the war, it was spread through germs that thrived in trenches.
Today, it is spread by lice that thrive among the homeless.
In both populations, the germ exploits a body that is weak and under
stress.
The bacteria that afflicted tens of thousands of soldiers in the trenches
during the World War I had not been seen in the United States until
1992, when 10 cases were identified among homeless people in
Seattle.
Koehler's new study found the infection in AIDS patients in San
Francisco who are poor, without homes and exposed to body lice.
The disease is caused by Bartonella quintana, the microbe that
sickened more than 1 million soldiers with trench fever during the
war, killing many.
It can also be caused by a related microbe, called Bartonella henselae,
which ordinarily causes cat scratch fever. B. henselae spreads from
cat to cat by fleas and then to people through cat scratches.
In their study, Koehler and her team found 26 of their patients were
infected with B. henselae and 23 with B. quintana.
Those germs can pose a risk to anyone, but the risk is worse and the
ailment more serious for those whose immune systems have been
weakened.
In soldiers, bacillary angiomatosis caused a relapsing feverish illness.
In AIDS patients, it can also cause skin lesions that are easily mistaken
for Kaposi's sarcoma, another HIV-related disease.
Because patients have severely damaged immune systems, infection
can lead to serious complications - including anemia, weight loss, the
growth of nonmalignant tumors that can hinder breathing and
damaged heart valves - and death.
Unlike soldiers of bygone days, the HIV-infected have access to
common antibiotics, called macro lide, which can prevent and treat the
bacillary angiomatosis infection.
But they are often not treated properly because their severe skin
lesions are mistaken for Kaposi's sarcoma. Diagnosing and treating
the infections "can make a huge difference in the quality of life" of
even late-stage AIDS patients, Koehler said, as well as help curb the
spread of the germs.
By LISA KRIEGER, San Francisco Examiner
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