The discovery of an unusual form of lice amongst homeless people in Edmonton may point to gaps in services.
"This is a marker of really severe deprivation of people living in really awful conditions," said infectious disease specialist Dr. Stan Houston.
Houston said he could hardly believe it when a patient at his clinic arrived with body lice.
The lice, the size of small ants, had caused severe itchy lesions on a man around 40.
Houston believes the man contracted the lice from a homeless shelter, but couldn't find any record in Canada of other cases of body lice, which can carry deadly diseases such as typhus and trench fever.
Lice found in extreme conditions
"When I read about this before, the most recent settings were in a refugee camp in Burundi and in street kids in Addis Ababa, Eithiopia...some of the worst conditions that people exist in on the planet.
"So things are getting worse in terms of the conditions people are living in, in inner-city Edmonton."
Dr. Mat Rose, at the inner-city Boyle McCauley Health Clinic, said he's been seeing an increase in body lice this year, up to three cases a week.
The numbers leave Rose wondering if some homeless people are struggling to get basic services.
"They simply don't have the same access to services that we (not only) take for granted, we wouldn't even think about," he said.
"Some of the things that we take very much for granted such as clean clothing, ability to launder clothing, ability to clean oneself, including showers."
With files from CBC's Gareth Hampshire