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A Cautionary Tale For Tourists Unwittingly Packing Pathogens

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The northern region of Canada is a majestic area. This area represents one of the places in the world to visit, if only to take in the incredible sights of Earth's natural beauty. One of the most active sites for tourism is Nunavik, located in Quebec. The combination of open tundra, wild forests and exotic wildlife make it a sure addition to many a bucket list.

The idea of a dream vacation to see snow-covered landscapes and exotic animals may offer a particular vision of the pristine nature of the North. Yet the area, despite all its wondrous beauty, still suffers from a variety of troubles normally seen in areas to the south. While some of these issues may have originated in these areas, more often than not, they are brought there by visitors.

A perfect example was outlined last week by a team of Canadian researchers. They revealed new threat to health in the North. Their findings highlight a potentially dark side to travel in which the victim isn't the visitor, but rather the indigenous population.

The team focused on a pathogen known as Cryptosporidium hominis. It's not a bacterium or virus, but a single celled protozoan creature. It has a dual life cycle consisting of a highly resistant dormant phase -- an oocyst -- and, when the environment is right, an infectious stage. When an oocyst gets into the gastrointestinal tract, it can undergo a transformation so it can invade human cells to grow and multiply.

The result of this attack is known as cryptosporidiosis, and it can be a vicious illness. The most common symptoms are profuse diarrhea, cramping, nausea, vomiting and, at times, low-grade fever.

Usually the infection is short-lived, lasting less than a week. But the infection can become persistent. If this happens, other troubles such as anorexia and recurrences of joint pain, headache and chronic fatigue may occur. The effects on children can be even more severe, resulting in complications with physical and mental development.

The incidence of C. hominis is usually quite low as the only host for this particular pathogen is the human body. But outbreaks have been seen over the years.

Most of the time, the event happens in an urban environment with a high density of people. Also the source is usually a setting where human fecal contamination can happen such as a breached public water supply or a recreational water park.

When this pathogen starting causing troubles in Nunavik back in 2013, researchers were puzzled as to what might be happening. As far as they could tell, the pathogen had not been seen in the North to any great extent. This was unexpected and they needed to understand the dynamics of the current rise in cases and determine the risk for future troubles.

Over the course of the next year, the team collected over 600 clinical samples from people living in 14 villages in Nunavik. In a lab in Montreal, the samples were examined for any sign of the pathogen. Upon identification of oocysts, they made a check in the positive column. Once the analysis was complete, they performed statistics to determine the incidence in terms of the overall population.

When the data came back, the researchers were faced with a rather unbelievable result. In a population of some 100,000 people, between 250 and 325 people would be infected.

To put this into perspective, in the rest of Quebec, that number would be less than one person. Expand that to the entire country of Canada and the number still would be only 2.4. Making the story even more troublesome was the fact the highest level of infections happened in children younger than five years of age.

The dramatic results forced to the team to examine what might be happening. Although many possible options were suggested, such as food and water, due to the widespread nature of the outbreak and the host-limitation of the parasite, there was really only one answer: people.

Someone brought the pathogen to Nunavik and started to spread it. Then, through travel and other interactions, people were transmitting the pathogen amongst themselves. The process happened silently over presumably years until the case load reached the tipping point in 2013.

The results of this study clearly show the importance of humans in the dissemination of infectious diseases. More importantly, the data reveal how a pristine environment can become unhealthy and possibly dangerous to the communities when unrestricted travel, such as vacationing, occurs. Granted, the authors did not find a so-called patient zero, but they did point out the pathogen had never been seen in the area previously.

This study also highlights the need for anyone wishing to travel to this region -- and indeed any remote region of the world -- to ensure their health prior to leaving.

Although we may believe ourselves to be nothing more than visitors, when it comes to infectious disease, we may play a much greater role than believed. It's why a visit to a travel doctor both before and after the trip is not only a good idea, but also may help to preserve an environment for the future.

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