The Black Death and Other Pandemics
Scott M. Jackson in Skin Disease and the History of Dermatology, 2023
Epidemic typhus is an infection with a bacterium called Rickettsia prowazekii that is transmitted from person to person by the human body louse; the bacterium resides in the feces of the louse. This louse is slightly different from the lice that infest the hair of schoolchildren. Instead, it infests the body and garments of persons of poor health and hygiene living in unclean conditions. Scratching the louse bites causes the person to rub the louse feces into the wound, thus inoculating the body with the bacterium. The signs and symptoms of typhus include fever, chills, headache, rapid breathing, body aches, cough, nausea, vomiting, confusion, and a rash. The red, petechial rash starts on the torso and spreads outward to the arms and legs. The mortality rate of untreated epidemic typhus is anywhere from 10 to 60 percent; with antibiotics, the condition is uniformly survivable. Epidemic typhus should be distinguished from endemic (murine) typhus, which occurs worldwide and is spread by the rat flea, and typhoid, a febrile condition with red spots on the skin caused by S. typhi, made famous in the twentieth century by the life and career of “Typhoid Mary.”
Typhus and social control
Roy MacLeod, Milton Lewis in Disease, Medicine, and Empire, 1988
Louse-borne typhus is ‘one of the greatest epidemic diseases of history’. As Hans Zinsser has shown in his incomparable Rats, Lice and History, it as been associated with nearly every great war and famine since the fifteenth century.27 A disease of ‘poverty, filth, human distress and overcrowding’, it can spread through a community or ravage a continent with great rapidity.28 The rickettsial organism responsible for the typhus infection can be transmitted to humans through ticks, rat- and mice-borne fleas, mites or lice, although the majority of cases with lethal consequence in South Africa as elsewhere was generally the louse-borne infection.29 Of rapid onset, classically typhus is recognized by fever, severe headache and muscular pains, a characteristic rash which appears about the fifth day and nervous symptoms (nightmares, tremors and twitching, stupor and delirium). The crisis is normally reached after fourteen to sixteen days. Fatality rises with age and deficient nutrition.30
Fleas (order Siphonaptera)
Eric S. Loker, Bruce V. Hofkin in Parasitology, 2015
Hosts and transmission Although they often have preferred hosts, most fleas are not highly host specific, readily transferring between hosts of different species. For instance, the cat flea C. felis readily uses both cats and dogs, as well as humans and other mammals as hosts. Various flea species transmit a variety of viral, bacterial, and eukaryotic parasites. The most important flea-borne disease is bubonic plague, caused by the bacterium Yersinia pestis. The most important vector species is probably the oriental rat flea Xenopsylla cheopis, but other species, including Pulex irritans, the human flea, are capable of transmitting plague. Rickettsia typhi, the bacterium responsible for murine typhus, is transmitted by several flea species. Myxoma virus, a pathogen in rabbits, is transmitted by several arthropods including fleas. C. felis, C. canis, and P. irritans all serve as intermediate hosts of the tapeworm Dipylidium caninum (see page 459). Trypanosomes in the subgenus Herpetosoma, and tapeworms in the genus Hymenolepis may also be vectored by fleas.
Scrub typhus (Tsutsugamushi disease) in a patient presenting with hemophagocytic syndrome
Published in Immunological Medicine, 2018
Takahiko Akagi, Tomoyuki Mukai, Shoko Tsuji, Yoshitaka Morita
Scrub typhus (also known as Tsutsugamushi disease) is a mite-borne infectious disease caused by O. tsutsugamushi (previously named Rickettsia tsutsugamushi). This disease has been mainly reported in East and Southeast Asia and in the northern regions in Australia [1]. This disease is most common in rural areas. Our patient lived in the rural area and also had been engaged in agriculture as the main occupation. Scrub typhus is associated with non-specific symptoms, including fever, headache, cough, myalgia, and rash. The rash occurs in about one half of all patients and spreads from the trunk to the extremities; this rash was present in our patient. At the site of the infecting chigger bite, a papule often appears and then turns to a characteristic eschar with a thick black crust. Although eschar is the pathognomonic feature of scrub typhus, reports of its frequency in patients with the disease are highly variable (7–80%) [1]. This feature might be overlooked without careful examination of the skin. In our case, the bite, which developed into a skin ulcer, was located on the buttock (Figure 1).
Clinical profile and outcomes of Scrub typhus in pregnant women presenting to a tertiary care hospital of North India
Published in Journal of Obstetrics and Gynaecology, 2023
Bhavana Yadav, Ranu Soni, Manisha Biswal, Vanita Suri, Minakshi Rohilla
The clinical manifestations of scrub typhus include flu-like symptoms, fever, maculopapular rash, eschar, headache, cough, myalgia, lymphadenopathy, vomiting and abdominal pain (Xu et al.2017). In a few cases, the disease progresses to multi-organ failure and death (Peter et al.2015). The case fatality rate (CFR) is 30% or even higher in untreated cases (Rajan et al.2016). It is a major cause of acute undifferentiated febrile illness (AUFI) in India, with high CFR and a link to adverse foetal outcomes in pregnant women having the illness (Kim et al.2006, Chrispal et al.2010). Despite the fact that scrub typhus is uncommon during pregnancy and the influence of scrub typhus on pregnancy is unknown, few research suggests that it is linked to adverse pregnancy outcomes (Watt et al.1999, Mathai et al.2003, Phupong and Srettakraikul 2004). Therefore, the aim of the present study was to evaluate the clinical outcome of scrub typhus infection in pregnancy.
Acute transverse myelitis following scrub typhus: A case report and review of the literature
Published in The Journal of Spinal Cord Medicine, 2020
Hyun-Seung Ryu, Bong Ju Moon, Jae-Young Park, Sang-Deok Kim, Seung-Kwon Seo, Jung-Kil Lee
Scrub typhus is an acute febrile illness and mite-borne bacterial infection caused by Orientia tsutsugamushi, an obligate gram-negative intracellular bacterium.1 The bacterium is transmitted by the bite of the trombiculid mite (chigger), which leaves the tell-tale pathognomonic eschar.1 Scrub typhus is known to occur throughout Asia, but recent evidence suggests that its range may be larger, with case reports in Asia-Pacific, including Korea.2 Patients with scrub typhus usually develop various complications, such as myocarditis, arrhythmia, and interstitial pneumonia.2 Neurological manifestations in scrub typhus are infrequent, but recently central nervous system (CNS) manifestations in the form of meningitis or meningoencephalitis have been reported.3,4 However, to our knowledge, scrub typhus invasion of the spinal cord is very rare.5 Hence, we present a case of acute transverse myelitis following scrub typhus with a review of the literature.
Related Knowledge Centers
- Epidemic Typhus
- Murine Typhus
- Rickettsia Prowazekii
- Infection
- Scrub Typhus
- Pathogenic Bacteria
- Body Louse
- Orientia Tsutsugamushi
- Rickettsia Typhi
- Flea