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is any one of several similar
Disease s caused by louse-borne bacteria. The name comes from the
Greek ''typhos'', meaning smoky or lazy, describing the state of mind of those affected with typhus. ''Rickettsia'' is endemic in rodent hosts, including mice and rats, and spreads to humans through mites, fleas and body lice. The
Arthropod vector flourishes under conditions of poor hygiene, such as those found in prisons or refugee camps, amongst the homeless, or until the middle of the 20th century, in armies in the field. In
Tropical countries, typhus is often mistaken for
Dengue Fever .
Epidemic typhus (also called "Jail Fever", "Hospital Fever", "Ship fever", "Famine fever", "Petechial Fever", and "louse-borne typhus")
1 is so named because the disease often causes epidemics following wars and natural disasters. The causative organism is ''. The disease is then transmitted to an uninfected human who scratches the louse bite (which itches) and rubs the feces into the wound. The
Incubation Period is one to two weeks. ''R. prowazekii'' can remain viable and virulent in the dried louse feces for many days. Typhus will eventually kill the louse, though the disease will remain viable for many weeks in the dead louse.
The symptoms set in quickly, and are among the most severe of the typhus family. They include severe
Headache , a sustained high
Fever ,
Cough ,
Rash , severe muscle pain, chills, falling blood pressure, stupor, sensitivity to light, and
Delirium . A rash begins on the chest about five days after the fever appears, and spreads to the trunk and extremities but does not reach the palms and soles. A symptom common to all forms of typhus is a
Fever which may reach 39°C (102°F).
The infection is treated with
Antibiotics . Intravenous fluids and
Oxygen may be needed to stabilize the patient. The mortality rate is 10% to 60%, but is vastly lower if antibiotics such as
Tetracycline are used early. Infection can also be prevented via vaccination. Brill-Zinsser disease is a mild form of epidemic typhus which recurs in someone after a long period of latency (similar to the relationship between
Chickenpox and
Shingles ). This type of recurrence can also occur in
Immunosuppressed patients.
Epidemic typhus hits hardest during times of war and privation. For example, typhus killed many thousands of prisoners in
Nazi Germany Concentration Camp s during
World War II . The abysmally low standards of hygiene enforced in camps such as
Theresienstadt and
Bergen-Belsen created conditions where diseases such as typhus flourished. A possible modern scenario for typhus epidemics would be in refugee camps during a major famine or natural disaster. This form of typhus is also known as "prison fever" or "ship fever", because it becomes prevalent in crowded conditions in
Prison s and aboard ships.
Endemic typhus (also called "flea-borne typhus" and "murine typhus" or "rat flea typhus") is caused by the bacteria '''' and transmitted by fleas carried by
Cat s or
Possum s. Symptoms of endemic typhus include
Headache ,
Fever ,
Chill s,
Myalgia ,
Nausea ,
Vomiting , and
Cough . Endemic typhus is highly treatable with antibiotics. Most people recover fully, but death may occur in the elderly, severely disabled or patients with a depressed immune system.
Scrub Typhus (also called "chigger-borne typhus") is caused by ''
Orientia Tsutsugamushi '' and transmitted by
Chigger s, which are found in areas of heavy scrub vegetation. Symptoms include fever, headache, muscle pain, cough, and
Gastrointestinal symptoms. More virulent strains of ''O. tsutsugamushi'' can cause
Hemorrhaging and
Intravascular Coagulation .
, April 1943.]]
The first major step in the development of the
Vaccine was
Charles Nicolle 's 1909 discovery that
Lice were the
Vectors for epidemic typhus. This made it possible to isolate the bacteria causing the disease and develop a vaccine; he was awarded the 1928
Nobel Prize In Physiology Or Medicine for this work. Nicolle attempted a vaccine but was not successful in making one that worked on a large enough scale.Gross, Ludwik (1996)
''How Charles Nicolle of the Pasteur Institute discovered that epidemic typhus is transmitted by lice: reminiscences from my years at the Pasteur Institute in Paris'' Proc. Natl. Acad. Sci. Vol. 93, pp. 10539-10540.
Henrique Da Rocha Lima in 1916 then proved that the bacteria ''Rickettsia prowazekii'' was the agent responsible for typhus; he named bacteria after
H. T. Ricketts and
Stanislaus Von Prowazek , two zoologists who died investigating a typhus epidemic in a prison camp in
1915 . Once these crucial facts were recognized,
Rudolf Weigl in 1930 was able to fashion a practical and effective vaccine production method by grinding up the guts of infected lice that had been drinking blood. It was, however, very dangerous to produce, and carried a high likelihood of infection to those who were working on it.
A safer .
worker distributes rat poison for typhus control in
Gulfport, Mississippi , ca. 1945.]]
The first description of typhus was probably given in ,
Girolamo Fracastoro , a
Florentine physician, described typhus in his famous treatise on viruses and contagion, ''De Contagione et Contagiosis Morbis''.
Fracastoro, Girolama , ''De Contagione et Contagiosis Morbis'' (1546).
Before a vaccine was developed in ,
Famine , and other conditions that result in mass causalties.
During the second year of the
Peloponnesian War (
430 BC ), the
City-state of
Athens in ancient
Greece was hit by a devastating epidemic, known as the
Plague Of Athens , which killed, among others,
Pericles and his two elder sons. The plague returned twice more, in 429 BC and in the winter of 427/6 BC. Epidemic typhus is one of the strongest candidates for the cause of this disease outbreak, supported by both medical and scholarly opinions.At a January 1999 medical conference at the
University Of Maryland , Dr. David Durack, consulting professor of medicine at
Duke University notes: ''"Epidemic typhus fever is the best explanation. It hits hardest in times of war and privation, it has about 20 percent mortality, it kills the victim after about seven days, and it sometimes causes a striking complication: gangrene of the tips of the fingers and toes. The Plague of Athens had all these features."'' see also: http://www.umm.edu/news/releases/athens.htmlGomme, A. W., edited by A. Andrewes and K. J. Dover. ''An Historical Commentary on Thucydides, Volume 5. Book VIII'' Oxford University Press, 1981. ISBN 0-19-814198-X.
Typhus also arrived in Europe with soldiers who had been fighting on the isle of
Cyprus . The first reliable description of the disease appears during the Spanish siege of
Moorish Granada in
1489 . These accounts include descriptions of fever and red spots over arms, back and chest, progressing to delirium, gangrenous sores, and the stink of rotting flesh. During the siege, the Spaniards lost 3,000 men to enemy action but an additional 17,000 died of typhus.
Typhus was also common in prisons (and in crowded conditions where
Lice spreads easily), where it was known as ''Gaol fever'' or ''Jail fever''. Gaol fever often occurs when prisoners are frequently huddled together in dark, filthy rooms. Imprisonment until the next term of court was often equivalent to a death sentence. It was so infectious that prisoners brought before the court sometimes infected the court itself. Following the Assize held at
Oxford in 1577, later deemed the
Black Assize , over 300 died from
Epidemic Typhus , including
Sir Robert Bell Lord Chief Baron of the Exchequer. The outbreak that followed, between 1557 to 1559, killed about 10% of the
English population. During the Lent
Assize Court held at
Taunton (1730) typhus caused the death of the
Lord Chief Baron , as well as the
High Sheriff , the sergeant, and hundreds of others. During a time when there were 241 capital offenses--more prisoners died from 'gaol fever' than were put to death by all the public executioners in the realm. In 1759 an English authority estimated that each year a fourth of the prisoners had died from Gaol fever.Ralph D. Smith, Comment, Criminal Law -- Arrest -- The Right to Resist Unlawful Arrest, 7 NAT. RESOURCES J. 119, 122 n.16 (1967) (hereinafter Comment) (citing John Howard, The State of Prisons 6-7 (1929)) (Howard's observations are from 1773 to 1775). Copied from State v. Valentine May 1997 132 Wn.2d 1, 935 P.2d 1294 In
London , typhus frequently broke out among the ill-kept prisoners of
Newgate Gaol and then moved into the general city population.
Epidemics occurred throughout
Europe from the
16th to the
19th Centuries , and occurred during the
English Civil War , the
Thirty Years' War and the
Napoleonic Wars . During
Napoleon 's retreat from
Moscow in
1812 , more
French soldiers died of typhus than were killed by the
Russia ns. A major epidemic occurred in
Ireland between 1816-19, and soon spread to England. Another typhus epidemic occurred during and after
Great Irish Famine between 1846 and 1849, and killed a large number of peasants.
In America, a typhus epidemic killed the son of
Franklin Pierce in
Concord, New Hampshire in 1843 and struck in
Philadelphia in 1837. Several epidemics occurred in
Baltimore ,
Memphis and
Washington DC between 1865 and 1873.
During
World War I typhus caused three million deaths in
Russia and more in
Poland and
Romania . De-lousing stations were established for troops on the Western front but the disease ravaged the armies of the Eastern front, with over 150,000 dying in Serbia alone. Fatalities were generally between 10 to 40 percent of those infected, and the disease was a major cause of death for those nursing the sick. Some historians assert that the disease may serve as a model for the use of biological weapons while in the field. Between 1918 and 1922 typhus caused at least 3 million deaths out of 20–30 million cases. In
Russia after World War I, during a civil war between the
White and
Red Armies , typhus killed three million, largely civilians. Even larger epidemics in the post-war chaos of Europe were only averted by the widespread use of the newly discovered
DDT to kill the lice on millions of refugees and displaced persons.
During
Concentration Camp s, infamous pictures of typhus victims' mass graves could be seen in footage shot at
Bergen-Belsen Concentration Camp . Thousands of prisoners held in appalling conditions in
Nazi concentration camps such
Theresienstadt and
Bergen-Belsen also died of typhus during World War II, including
Anne Frank and her sister Margot.
Following the development of a vaccine during World War II epidemics occur only in
Eastern Europe , the
Middle East and parts of
Africa .
- (1847) In Jane Eyre by Charlotte Bronte , an outbreak of typhus occurs in Jane's school Lowood, highlighting the unsanitary conditions the girls live in.
- (c. 1974) In Little House On The Prairie (TV Series), an outbreak of typhus hits Walnut Grove killing several. It is traced to below market cost Corn Meal residents had been purchasing to avoid the high cost of the local Mill . The corn meal had been infested by rats.
- (1978) O'Brian, Patrick . '' Desolation Island '' Fictional presentation of typhus - while sailing aboard the ''Leopard'' an outbreak of 'gaol-fever' strikes the crew.
