The History of Epidemic Typhus
- Authors: Emmanouil Angelakis1, Yassina Bechah2, Didier Raoult3
- Editors: Michel Drancourt4, Didier Raoult5
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VIEW AFFILIATIONS HIDE AFFILIATIONSAffiliations: 1: Unité de Recherche sur les Maladies Infectieuses Transmissibles et Emergentes, Aix-Marseille Université, UM63, CNRS 7278, IRD 198, INSERM U1095, Marseille, France; 2: Unité de Recherche sur les Maladies Infectieuses Transmissibles et Emergentes, Aix-Marseille Université, UM63, CNRS 7278, IRD 198, INSERM U1095, Marseille, France; 3: Unité de Recherche sur les Maladies Infectieuses Transmissibles et Emergentes, Aix-Marseille Université, UM63, CNRS 7278, IRD 198, INSERM U1095, Marseille, France; 4: Aix Marseille Université Faculté de Médecine, Marseille, France; 5: Aix Marseille Université Faculté de Médecine, Marseille, France
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Received 19 November 2015 Accepted 23 November 2015 Published 12 August 2016
- Correspondence: Emmanouil Angelakis, [email protected]

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Abstract:
Epidemic typhus caused by Rickettsia prowazekii is one of the oldest pestilential diseases of humankind. The disease is transmitted to human beings by the body louse Pediculus humanus corporis and is still considered a major threat by public health authorities, despite the efficacy of antibiotics, because poor sanitary conditions are conducive to louse proliferation. Epidemic typhus has accompanied disasters that impact humanity and has arguably determined the outcome of more wars than have soldiers and generals. The detection, identification, and characterization of microorganisms in ancient remains by paleomicrobiology has permitted the diagnosis of past epidemic typhus outbreaks through the detection of R. prowazekii. Various techniques, including microscopy and immunodetection, can be used in paleomicrobiology, but most of the data have been obtained by using PCR-based molecular techniques on dental pulp samples. Paleomicrobiology enabled the identification of the first outbreak of epidemic typhus in the 18th century in the context of a pan-European great war in the city of Douai, France, and supported the hypothesis that typhus was imported into Europe by Spanish soldiers returning from America. R. prowazekii was also detected in the remains of soldiers of Napoleon’s Grand Army in Vilnius, Lithuania, which indicates that Napoleon’s soldiers had epidemic typhus. The purpose of this article is to underscore the modern comprehension of clinical epidemic typhus, focus on the historical relationships of the disease, and examine the use of paleomicrobiology in the detection of past epidemic typhus outbreaks.
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Citation: Angelakis E, Bechah Y, Raoult D. 2016. The History of Epidemic Typhus. Microbiol Spectrum 4(4):PoH-0010-2015. doi:10.1128/microbiolspec.PoH-0010-2015.




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Abstract:
Epidemic typhus caused by Rickettsia prowazekii is one of the oldest pestilential diseases of humankind. The disease is transmitted to human beings by the body louse Pediculus humanus corporis and is still considered a major threat by public health authorities, despite the efficacy of antibiotics, because poor sanitary conditions are conducive to louse proliferation. Epidemic typhus has accompanied disasters that impact humanity and has arguably determined the outcome of more wars than have soldiers and generals. The detection, identification, and characterization of microorganisms in ancient remains by paleomicrobiology has permitted the diagnosis of past epidemic typhus outbreaks through the detection of R. prowazekii. Various techniques, including microscopy and immunodetection, can be used in paleomicrobiology, but most of the data have been obtained by using PCR-based molecular techniques on dental pulp samples. Paleomicrobiology enabled the identification of the first outbreak of epidemic typhus in the 18th century in the context of a pan-European great war in the city of Douai, France, and supported the hypothesis that typhus was imported into Europe by Spanish soldiers returning from America. R. prowazekii was also detected in the remains of soldiers of Napoleon’s Grand Army in Vilnius, Lithuania, which indicates that Napoleon’s soldiers had epidemic typhus. The purpose of this article is to underscore the modern comprehension of clinical epidemic typhus, focus on the historical relationships of the disease, and examine the use of paleomicrobiology in the detection of past epidemic typhus outbreaks.

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Figures

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FIGURE 1
Human body louse (Pediculus humanus corporis). Typical size is 2 to 4 mm.

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FIGURE 2
Classic abdominal skin rash of typhus.

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FIGURE 3
Actual foci of epidemic typhus.

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FIGURE 4
General view of the burial site in Douai, France.

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FIGURE 5
Imperial-type button found in the grave in Vilnius.
Tables

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TABLE 1
Some epidemiological features of typhus group Rickettsiae

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TABLE 2
History of epidemic typhus and the description of Rickettsia prowazekii
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