Typhus Fever (Epidemic Typhus) (Louse Borne Typhus)

Typhus fever is an illness characterized by sudden onset of fever, chills, muscles pain and rash caused by the bacteria rickettsia prowazekii. It is transmitted through the bite of the body louse. Person to person transmission occurs as the louse goes from person to person.

If untreated, the illness can become severe resulting in death in nearly 40% of individuals.

The illness can relapse years after the primary event but is usually milder and is called Brill-Zinsser disease.

Where does it occur?

It is seen in Mexico, Central & South America, Africa and Asia. Epidemics break out during times of war, famine and flooding due to crowded, unhygienic conditions. In the United States, the flying squirrel carries the bacteria and can be spread through infected fleas.

How is it transmitted?

It is transmitted through the bite of infected louse and possibly through the bite of fleas that are associated with flying squirrels.

What is the risk for travelers?

The risk is generally low, unless staying in overcrowded, unhygienic areas.

How soon after exposure will one develop symptoms?

Symptoms usually develop 1-2 weeks after exposure.

What are the signs and symptoms?

One develops sudden onset of fever, chills, body aches, muscle pain and severe headache. The fever is typically constant without any relief. Approximately 4-5 days later a red, flat to sandpaper like rash that blanches with touch develops. These start around the arm pits and chest and spreads downward. The rash subsequently becomes darker and purplish, the face, palms and soles are typically spared.

Are there any lab tests to diagnose the illness?

Blood antibody (IgM/IgG) tests and PCR tests are available.

Is there any treatment?

Antibiotic called Tetracycline is effective.

Is the infected person contagious?

If the infected person has lice, it can jump to another close contact and thus spread the infection. Close contacts of sick individuals need to be quarantined for 2 weeks.

An individual with typhus fever needs to be isolated and deloused for the above reason.

What preventive measures can be taken?

Avoid lice infestation by avoiding unhygienic, crowded environments.

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