Typhus
Typhus | |
---|---|
Other names | Typhus fever |
parasites[1] | |
Risk factors | Poor sanitation |
Prevention | Avoiding exposure to organisms known to carry the disease |
Treatment | Doxycycline[2] |
Frequency | Rare[3] |
Typhus, also known as typhus fever, is a group of
The diseases are caused by specific types of
Typhus has been described since at least 1528.[7] The name comes from the Greek tûphos (τῦφος), meaning hazy or smoky and commonly used as a word for delusion, describing the state of mind of those infected.[7] While "typhoid" means "typhus-like", typhus and typhoid fever are distinct diseases caused by different types of bacteria.[8] Note, however, that in some languages such as German, the term typhus does mean the "typhoid fever", caused by specific strains of Salmonella typhi bacteria, and the here depicted "typhus" is called lice fever.
Signs and symptoms
These signs and symptoms refer to epidemic typhus, as it is the most important of the typhus group of diseases.[9]
Signs and symptoms begin with sudden onset of fever and other flu-like symptoms about one to two weeks after being infected.[10] Five to nine days after the symptoms have started, a rash typically begins on the trunk and spreads to the extremities. This rash eventually spreads over most of the body, sparing the face, palms, and soles. Signs of meningoencephalitis begin with the rash and continue into the second or third weeks.[citation needed] Other signs of meningoencephalitis include sensitivity to light (photophobia), altered mental status (delirium), or coma. Untreated cases are often fatal.[11]
Signs and symptoms of scrub typhus usually start within 1 to 2 weeks after being infected. These symptoms include fever, headaches, chills, swollen lymph nodes, nausea/vomiting, and a rash at the site of infection called an eschar. More severe symptoms may damage the lungs, brain, kidney, meninges, and heart.[12]
Causes
Multiple diseases include the word "typhus" in their descriptions.[13] Types include:
Condition | Bacterium | Reservoir/vector | Notes |
---|---|---|---|
Epidemic louse-borne typhus | Rickettsia prowazekii | Body louse | When the term "typhus" is used without qualification, this is usually the condition described. Historical references to "typhus" are now generally considered to be this condition.[citation needed] |
Murine typhus or "endemic typhus" | Rickettsia typhi | Fleas on rats | |
Scrub typhus | Orientia tsutsugamushi | ||
Spotted fever | Rickettsia spotted fever group | Ticks | Includes Boutonneuse fever, Rocky Mountain spotted fever, Queensland tick typhus and other variants. |
Diagnosis
The main method of diagnosing typhus of all types is laboratory testing. It is most commonly done with an indirect immunofluorescence antibody IFA test for all types of typhus. This tests a sample for the antibodies associated with typhus. It can also be done with either immunohistochemistry (IHC) or polymerase chain reaction (PCR) tests excluding scrub typhus. Scrub typhus is not tested with IHC or PCR but is instead tested with the IFA test as well as indirect immunuoperoxidase (IIP) assays.[14]
Prevention
As of 2024, no vaccine is commercially available.
Scrub typhus
Scrub typhus is caused by mites, so avoid the outdoors when scrub is common in the area. Make sure your clothing is treated with permethrin to prevent mite bites. Lastly, make sure to use bug spray to keep mites away as well. For children and babies, you additionally have to make sure their clothing covers their limbs. For babies put a mosquito cover over their stroller which also protects them from mites.[16]
Epidemic typhus
Epidemic typhus is caused by body lice and thrives in areas with overcrowding. To avoid lice you should stay away from highly populated areas. Also, make sure to regularly clean yourself and your clothing to help kill louse. This also goes for things like bedding and towels. Make sure to not share any fabric items with anyone who has lice or typhus. Lastly, treat clothing with permethrin because it helps kill lice.[3]
Murine typhus
Murine typhus is caused by flea bites so take steps to avoid fleas. This can be done by making sure pets do not have fleas and if they do, treat them, stay away from wild animals, use insect repellent to keep fleas away, and wear gloves when dealing with sick or dead animals. Take steps to ensure rodents or other wildlife do not get into your home.[17]
Treatment
The American Public Health Association recommends treatment based upon clinical findings and before culturing confirms the diagnosis.[18] Without treatment, death may occur in 10% to 60% of people with epidemic typhus, with people over age 50 having the highest risk of death.[19] In the antibiotic era, death is uncommon if doxycycline is given. In one study of 60 people hospitalized with epidemic typhus, no one died when given doxycycline or chloramphenicol.[20]
Epidemiology
According to the World Health Organization, in 2010 the death rate from typhus was about one of every 5,000,000 people per year.[21]
Only a few areas of epidemic typhus exist today. Since the late 20th century, cases have been reported in Burundi, Rwanda, Ethiopia, Algeria, and a few areas in South and Central America.[22][23][24][25]
Except for two cases, all instances of epidemic typhus in the United States have occurred east of the
History
Middle Ages
The first reliable description of typhus appears in 1489 AD during the Spanish siege of
In historical times,[
Early modern epidemics
Epidemics occurred routinely throughout Europe from the 16th to the 19th centuries, including during the English Civil War, the Thirty Years' War, and the Napoleonic Wars.[32] Pestilence of several kinds raged among combatants and civilians in Germany and surrounding lands from 1618 to 1648. According to Joseph Patrick Byrne, "By war's end, typhus may have killed more than 10 percent of the total German population, and disease in general accounted for 90 percent of Europe's casualties."[33]
19th century
During Napoleon's retreat from Moscow in 1812, more French soldiers died of typhus than were killed by the Russians.[34]
A major epidemic occurred in Ireland between 1816 and 1819, during the famine caused by a worldwide reduction in temperature known as the Year Without a Summer. An estimated 100,000 people perished. Typhus appeared again in the late 1830s, and yet another major typhus epidemic occurred during the Great Irish Famine between 1846 and 1849. The typhus outbreak along with typhoid fever is said to be responsible for 400,000 deaths.[35] The Irish typhus spread to England, where it was sometimes called "Irish fever" and was noted for its virulence. It killed people of all social classes, as lice were endemic and inescapable, but it hit particularly hard in the lower or "unwashed" social strata.[36]
In the
In
20th century
Typhus was
In 1922, the typhus epidemic reached its peak in Soviet territory, with some 20 to 30 million cases in Russia.[43] Although typhus had ravaged Poland with some 4 million cases reported, efforts to stem the spread of disease in that country had largely succeeded by 1921 through the efforts of public health pioneers such as Hélène Sparrow and Rudolf Weigl.[44] In Russia during the civil war between the White and Red Armies, epidemic typhus killed 2–3 million people, many of whom were civilians.[41][43][45][46] In 1937 and 1938 there was a typhus epidemic in Chile.[47]
During
The first typhus vaccine was developed by the
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Charles Nicolle received the 1928 Nobel Prize in Medicine for his identification of lice as the transmitter of epidemic typhus.
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A US soldier is demonstrating DDT hand-spraying equipment. DDT was used to control the spread of typhus-carrying lice.
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A Civilian Public Service worker distributes rat poison for typhus control in Gulfport, Mississippi, around 1945.
21st century
Beginning in 2018, a typhus outbreak spread through
References
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- ^ a b c d e f "Epidemic Typhus | Typhus Fevers". Centers for Disease Control and Prevention. 7 March 2017. Archived from the original on 26 March 2017. Retrieved 27 March 2017.
- ^ a b c d "Scrub Typhus". Centers for Disease Control and Prevention. 7 March 2017. Archived from the original on 26 March 2017. Retrieved 26 March 2017.
- ^ a b c d "Murine Typhus". Centers for Disease Control and Prevention. Archived from the original on 26 March 2017. Retrieved 26 March 2017.
- ^ "WHO | Typhus". www.who.int. May 1997. Archived from the original on 27 March 2017. Retrieved 26 March 2017.
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