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Outbreaks of intestinal bug kill at least 89 in Canadian hospitals

Infection Control Monitor, June 15, 2004

A deadly outbreak of a highly virulent strain of a common intestinal bug has hit Montreal hospitals, killing at least 79 people in the last year, the (Montreal) Gazette reports.

A similar epidemic has hit Calgary, where at least 10 people have died of infections, according to the Canadian Medical Association Journal. Physicians identified the bug in both cities as Clostridium difficile, which has caused thousands of cases of severe diarrhea.

Treatment options include the surgical removal of portions of infected colons.

In Montreal, physicians have expressed alarm at the number of deaths. Public health authorities chose to keep news of the infections secret for months, and only commented June 4 after the medical journal made its report public.

The C. difficile outbreaks have already caused more deaths in Canada than SARS did in 2003, when 44 Ontario residents died.

C. difficile is a spore-forming bacterium that is part of the normal "intestinal flora." An aggressive overuse of antibiotics can disrupt the delicate balance of bacteria in the gut, resulting in an abnormally large growth in C. difficile. Antibiotic-resistant strains can result that cause infection, particularly in the elderly and those with weakened immune systems.

The resistant bug is spread from person to person through fecal-oral contact. It can survive for up to 70 days outside the body on items such as the doorknob of a patient's room.

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