Thefour postulates of the Germ Theory of Disease, which states that diseases arecaused by microorganisms, that had been laid down by Robert Koch in the late 19thcentury were a remarkable advancement in the field of Microbiology, andprovided an understanding of the cause, and possible cure of various diseases. Knownby various synonyms such as camp fever, jail fever, famine fever, putrid fever,louse-borne typhus, etc., the infamous bacterial disease typhus has beenresponsible for various epidemics in history. As the names suggest, theseepidemics tend to follow conditions when social organisation is disrupted, andpublic health and personal hygiene is compromised. Epidemic typhus is caused bythe bacterium Rickettsia prowazekii, and transmitted by Pediculushumanus humanus, the body louse, as discovered by Charles Nicolle in 1909.
Manifestations:Epidemictyphus is a life-threatening, acute exanthematic feverish disease that isprimarily characterised by the abrupt onset of fever with painful myalgia, asevere headache, malaise and a rash. Non-specific symptoms sometimes include acough, abdominal pain, nausea and diarrhoea. The rash, which is acharacteristic of typhus fever, appears on the abdomen a few days after theonset of the symptoms, and radiates centrifugally to the extremities. Gangreneand necrosis of the extremities, leading to the need for amputation, may alsobe observed. Neurologic symptoms include confusion and drowsiness. Coma,seizures and focal neurologic signs may develop in a minority of patients.History:Thefirst written recordings of typhus came in 1489 during the Spanish army’s siegeof Granada.
An epidemic of louse-borne typhus had struck the Spanish army, andwithin a month had killed 17,000 of the original 25,000 soldiers. Of the totalwar causalities, only 3,000 Spaniards had died in actual combat. The remnantsof the Spanish army fled, and in so doing, introduced typhus to many otherparts of Europe. In 1546, Girolamo Fracastoro, a Florentine physician,described the pestilential disease in his famous treatise on viruses andcontagion, De Contagione et Contagiosis Morbis. In 1759 authoritiesestimated nearly 25% of English prisoners lost their lives to this disease,thus earning the name gaol or jail fever. A year later, the term typhus wascoined, stemming from the Greek word typhos, meaning “smoky” or”hazy,” evoking the delirious state one can develop while infected. It had alsoafflicted the soldiers of Napoleon’s Grand Army in Vilnius in 1812 after theirretirement from Russia.
It is estimated that fewer than 100,000 French soldierslost their lives to Russian soldiers, while as many as 300,000 French soldiersperished from typhus.