Four cases of trench fever, a rare condition spread by lice that affected soldiers during World War I, have been identified in Denver this year, Kaiser Health News reports.
Trench fever is caused by the bacteria Bartonella quintana, which live in the digestive systems of body lice and is spread through their feces. Symptoms of trench fever include relapsing fever, bone pain, headache and nausea.
Trench fever has been considered a reemerging disease since the 1990s, according to Kaiser Health News.
"Old infectious diseases always still have the potential to come back," said Michelle Barron, MD, medical director of infection prevention and control at UCHealth University of Colorado Hospital in Aurora. She also told Kaiser Health News that before the current outbreak she had notseen a trench fever case in her 20 years practicing in Colorado.
There have been recent outbreaks of the disease in San Francisco and Seattle, concentrated in homeless encampments. The outbreak in Denver is also among the homeless population, though state health officials are looking for other common threads. The cases occurred months apart, Kaiser Health News reports.
State public health officials issued an advisory for the disease July 16 and asked physicians to keep an eye out for more cases.
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