The consultant suspected an alternative diagnosis of flying squirrel-associated epidemic typhus, discontinued the current antibiotic regimen, and instituted intravenous doxycycline therapy.
This study will analyze 40 serologically or molecularly confirmed cases of epidemic typhus reported in the US between 1976 and 2006 in order to determine significant demographic, environmental, and epidemiological risk factors for epidemic typhus today, to describe the most significant presenting features of sporadic epidemic typhus, and to promote early diagnosis and antibiotic therapy of potentially fatal or recrudescent epidemic typhus.
(30) If the 1922 estimate above is added to Tarasevich's figures, it appears that between 44 million and 52 million people contracted epidemic typhus
or relapsing fever in Russia in the 1918-22 period, and between 4.4 million and 5.2 million people died.
Epidemic typhus remains a threat in the rural highlands of South America, Africa, and Asia.
From the late 19th century until 1963, the annual mortality rate of epidemic typhus in the rural state of Mexico decreased steadily from 52.4 to 0.1 cases/100,000 persons, and by 1979 no cases had been reported for 10 years.
In the case presented here, we found no stress factor, no immunosuppression, and no medical history of epidemic typhus.
Brill-Zinsser disease should be considered as a possible diagnosis for acute fever in any patient who has lived in an area where epidemic typhus is endemic.
Nicolle's many accomplishments include the discovery that epidemic typhus is transmitted by body lice (Pediculus humanis corporis), discovery of the phenomenon of inapparent infection, and possibly the first isolation of human influenza virus after experimental transmission.
Of all the problems Nicolle faced in Tunis, however, epidemic typhus was, in his words, "the most important and the least explored." He studied it for the next 7 years.
Surveillance for epidemic typhus
was discontinued in the United States in the 1950s because the illness had not been reported in decades and prevalence of body lice infestation in this country has been low (1).
Arthropods are collected and PCR-screened for pathogens such as Bartonella, the epidemic typhus
rickettsia, and Borrelia recurrentis.
Rickettsia prowazekii is the causative agent of epidemic typhus
and also a potential bioterrorism agent.