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Chapter 5 : Epidemic Typhus: a Forgotten but Lingering Threat

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Epidemic Typhus: a Forgotten but Lingering Threat, Page 1 of 2

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Abstract:

The impact of louse-borne, or epidemic, typhus, which is caused by , on populations is of historical significance but has passed from current concern. Whenever large numbers of people were crowded together under less than sanitary conditions, typhus appeared. Louse-borne typhus remains endemic in the mountainous regions of the Americas, the Himalayas, Afghanistan, and Africa. The disease is maintained in an endemic cycle of transmission that remains barely detectable. Occasionally, conditions that favor epidemic transmission occur. Epidemic typhus spreads into populations at higher elevations, where colder conditions prevailed and infestations with lice were prevalent. Epidemic typhus is characterized clinically by sudden onset, sustained high fever of about 2 weeks duration, a maculopapular rash, and altered mental state. There is effective antimicrobial therapy for the typhus fevers. The response to tetracyclines or chloramphenicol is rapid and efficacious. Most patients become afebrile within 48 h of treatment, and single-dose doxycycline therapy is effective in epidemic situations. Strategies for control of epidemics of louse-borne typhus in refugee camps must include two elements of intervention: (i) antimicrobial treatment of patients with suspected cases and (ii) delousing of the entire population at risk. Long-term louse control or eradication depends on correction of the complex environmental, economic, cultural, educational, and political factors that contribute to louse infestations.

Citation: Olson J. 1999. Epidemic Typhus: a Forgotten but Lingering Threat, p 67-72. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 3. ASM Press, Washington, DC. doi: 10.1128/9781555818418.ch5

Key Concept Ranking

Infectious Diseases
1.0440699
Toxic Shock Syndrome
0.7226621
Infection
0.5460113
Rickettsia prowazekii
0.5090633
Vaccines
0.45083755
1.0440699
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Figures

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Figure 1

Epidemic typhus cases. Ethiopia, 1985 to 1991. Data from the Ethiopian Health and Nutrition Research Institute

Citation: Olson J. 1999. Epidemic Typhus: a Forgotten but Lingering Threat, p 67-72. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 3. ASM Press, Washington, DC. doi: 10.1128/9781555818418.ch5
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Figure 2

Epidemic typhus cases by month, refugee camps, Burundi, 1997.

Citation: Olson J. 1999. Epidemic Typhus: a Forgotten but Lingering Threat, p 67-72. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 3. ASM Press, Washington, DC. doi: 10.1128/9781555818418.ch5
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References

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1. Kantal, A. M., and G, A. Messih. 1943. Typhus fever (review of 11,410 cases) symptomatology, laboratory investigations and treatment. J. Egypt. Public Health Assoc. 1:126213.
2.Krause, D, W., P. L, Perine, J. E. McDade, and S, A. Awoke. 1975, Treatment of louse-borne typhus fever with chloramphenicol. tetracycline or doxycycline. East Afr. Med. J. 52:421427.
3. Moe, J. B.,, and C. E. Pederson. 1980. The impact of rickettsial diseases on military operations. Mil. Med. 145:780785.
4. Perine. P, L.,, B. P. Chandler,, D. K Krause,, P. McCardle,, S. Awoke,, E. Hahte-Gabr,, C, L. Wisseman. Jr.,, and J. E. McDade. 1992. A c1inico·epidemiological study of epidemic typhus in Africa. Clin. Infect. Dis. 14:11491158.
5. Prinzing, F. 1916. Epidemics Resulting from Wars. The Clarendon Press. Oxford, United Kingdom.
6.Raou1t. D., J. B. Ndibokubwayo, H. Tissot-Dupont. V. Roux. B. Faugere, R. Abegbinni. and R. J. Birtles. 1998. Outbreak of epidemic typhus associated with trench fever in Burundi. Lancet 352:353358.
7.Reilly. P. J. and R. W. Kalinske. 1980. Brill-Zinsser disease in North America. West J. Med. 133:338340.
8. Snyder, J. C. 1947. Typhus fever in the Second World War. Calif. Med, 66:310.
9. Strong, R. P.,, G. C. Shattuck. A. W. Sellards, H. Zinsser, and J. G. Hopkins. 1920. Typhus Fever with Particular Reference to the Serbian Epidemic. American Red Cross, Cambridge, Mass..
10. Zinsser, H. 1944. Rats, Lice and History. The Atlantic Monthly Press (Little. Brown & Co,). Boston, Mass. .

Tables

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Table 1

Typhus surveillance in refugee camps, Burundi, 1997

Citation: Olson J. 1999. Epidemic Typhus: a Forgotten but Lingering Threat, p 67-72. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 3. ASM Press, Washington, DC. doi: 10.1128/9781555818418.ch5

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