Epidemic Louse-Borne Typhus Fever

Epidemic louse-borne typhus fever is one of three versions of the disease typhus, caused by three different bacteria in the Rickettsia genus, i.e, Rickettsia prowazekii, Rickettsia typhi, and Orientsia tsutsugamushi. Louse-borne typhus is caused by Rickettsia prowazekii. This disease usually occurs primarily in cold climates where human infestation with lice may occur and usually where groups of people are crowded together with poor sanitation and malnutrition. 

The risk for travellers of acquiring epidemic louse-borne typhus fever is low, however, this risk is increased for those who may live and work in remote areas (anthropologists, archeologists, geologists, medical personnel, missionaries).

All people are potentially susceptible to epidemic louse-borne typhus. However, prior infection creates long lasting immunity.

Epidemic typhus may begin with the sudden onset of severe headache, aches, chills and fever. A skin rash often appears on the 5th or 6th day of illness, usually on the upper part of the body. The rash then spreads to all parts of the body, except the palms and soles. The fever usually subsides after 2 weeks. Other symptoms include cough, light sensitivity, and delirium. Mild infections may occur, especially in children.

The disease may reappear as a mild illness years after the first infection. This is known as Brill-Zinsser Disease, and people with this disease will transmit the bacteria to any lice that bite them, possibly causing new outbreaks.

Without treatment, 10-40 percent of people with epidemic louse-borne typhus fever will die. 

A single dose of doxycycline (200 mg.) will usually cure patients.

The germs (Rickettsia) that cause epidemic typhus are transmitted by infected body lice. Therefore, this disease can occur anywhere that body lice are found, usually in colder climates when infested clothing is not laundered. The disease is most commonly found in the mountains of Mexico, in Central and South America, in parts of Africa and in many countries in Asia. Outbreaks of this disease are most common in homeless populations, refugee camps, and places that have experienced war or natural disasters.