Caring for a community in need

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The tragedy of Walkerton has emphasized the importance of bacteria as an agent causing disease in our society. In May 2000, seven people died after a terrible rainstorm washed E. coli bacteria from cattle manure into a shallow town well. Known potential long-term effects of E. coli infection include gastrointestinal (GI) problems, kidney problems, gall bladder disease, arthritis, diabetes and even brain damage. Of the 2,300 people who became sick after drinking the contaminated water, more than 1,000 still exhibit symptoms of gastrointestinal illness, often referred to as post-infectious irritable bowel syndrome.

Hamilton Health Sciences doctors John Marshall and Steven Collins are sharing their expertise as gastrointestinal investigators for the Walkerton Health Study. The seven-year study funded by Ontario’s Ministry of Health and Long-Term Care began in February 2002, to assess and evaluate long-term effects of an E. coli infection. The study is led by doctors at the University of Western Ontario and also includes investigators specializing in nephrology (kidneys) and infectious disease.

“We initiated contact with the government shortly after the outbreak to express our interest in monitoring and studying the Walkerton population,” said Marshall. “From a treatment perspective, our involvement will allow us to follow infected people closely, and identify and treat serious gastrointestinal problems at an earlier stage.” Every person who drank contaminated water was given the opportunity to complete a questionnaire regarding their health and well-being since May 2000. Appropriate candidates were invited to join the study and will be assessed annually until 2009. Patients requiring on-going care are referred to a local family doctor or specialist.

The Walkerton study provides a significant opportunity to advance our knowledge of serious GI infection.

“No one has previously had an opportunity to study a large population where the details of GI infection were so well documented, and follow-up so complete,” said Marshall.

“We have known for years that some people suffer post-infectious irritable bowel syndrome. However, we know very little about why some people continue to suffer while others don’t, what causes the symptoms, how long it lasts and whether it leads to other diseases. This study will allow us to answer some of those questions.”