WINNIPEG — An outbreak of potentially deadly flesh-eating disease erupted among Winnipeg’s homeless last year, infecting 12 people with an invasive bacteria that spreads rapidly and causes severe pain and disfiguration.
Winnipeg health officials did not publicly disclose that a cluster of cases was reported in the city area between April and October 2008 until questioned by the Winnipeg Free Press this week.
Dr. Pierre Plourde, a Winnipeg medical officer of health, said inner-city shelters were alerted about the spike in cases and told to watch for anyone with wounds or sore throats who may be at an increased risk of developing the infection.
He said there were four or five strains of flesh-eating disease that were reported and there was no evidence that anyone infected transmitted the disease to another person.
Nine of the 12 people infected had recently suffered a major injury, including one person who was severely burned in a fire. Plourde said no one infected died of flesh-eating disease.
Manitoba’s chief medical examiner Dr. Thambirajah Balachandra confirmed a total of five people died from flesh-eating disease in 2008, including one death in August, October and November — the same time the outbreak occurred in downtown Winnipeg.
Plourde could not confirm whether any patients had limbs amputated.
Plourde said the bacteria can infect anyone, but people who have weakened immune systems or open wounds, or who have recently undergone surgery, are more at risk. He said the city’s homeless population tends to delay seeking medical treatment until they’re in dire need.
Flesh-eating disease is a bacteria that quickly destroys tissue and muscles, and originates from the same bacteria that causes strep throat. It can cause death in as little as 12 to 24 hours, but can be treated with heavy doses of antibiotics and with surgery to remove diseased tissue. Often, afflicted limbs are amputated to save someone’s life.
There are typically less than four cases of flesh-eating disease in Manitoba a year and Plourde said health officials first noticed a pattern among the cluster of cases in September. He said no new cases have been reported since October and that the public wasn’t notified of the outbreak since it was concentrated among a small number of inner-city residents.
“We have no evidence the general public was at risk during the cluster of cases in 2008, therefore (there was) no need to notify or alarm the general public. It was a very focused cluster in a relatively small population group,” Plourde said.
“It can happen in a nursing home, in can happen in a group home, shelter, (and) again the public doesn’t need to know about it if the public isn’t at risk.”
Although flesh-eating disease is considered rare, Plourde said the province recorded 16 cases in 2008 — four times the number that is typically reported.
Manitoba Health disease statistics show the number of flesh-eating cases has skyrocketed in the past three years: 56 cases were reported between 2006 and October 2008, compared to only 12 total cases in 2005 and 2004.
At least seven Manitobans infected with the invasive bacteria have died since 2006. Officials are still reviewing one suspected death from 2008.
Plourde said it’s difficult to explain the recent outbreak, but emphasized that diseases tend to go in waves and more people may be carrying strep throat bacteria. He said shelter overcrowding and lack of proper hygiene among inner-city homeless could explain the rash of cases.
He said the best way to avoid becoming sick is to practice proper handwashing and wound care and report to a physician if you experience a skin rash at the same time as sore throat.
“Everybody can potentially get this disease, so that’s what unnerving about this bacteria,” Plourde said. “Fortunately, it’s still a very rare thing to see.”