Whipple's disease in southern New Brunswick, Canada: A case series

Whipple's disease is a rare systemic disorder caused by infection with Tropheryma whipplei. An increased number of cases of this infectious disease have recently been noted by practitioners in southern New Brunswick, Canada. We analyzed a series of Whipple's disease cases so as to better understand factors that could contribute to its increased incidence in southern New Brunswick.

We conducted a retrospective case series of patients diagnosed with Whipple's disease in the health zone surrounding Saint John, New Brunswick, between January 2020 and January 2024. Demographic data, medical histories, patient assessments, pertinent investigations, and clinical outcomes were reviewed for each case and extracted for further analysis.

A total of four cases of Whipple's disease were identified. The estimated annual incidence was 5.7 cases per 1 million during the study time frame - a value nearly six times greater than the incidence proposed in the literature. The four cases varied widely in terms of presenting clinical features. No unifying environmental exposure was immediately apparent among the identified patients.

The recent incidence of Whipple's disease in southern New Brunswick is higher than expected based on existing literature. Whipple's disease has a predilection for White and elderly individuals, and these populations have higher prevalence in southern New Brunswick when compared to national averages. Environmental triggers of Whipple's disease have been previously described, and such a trigger may have been present among the study population. Large-scale epidemiologic studies are necessary to further assess possible demographic, environmental, and disease-related triggers of Whipple's disease in Canada.