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Typhus Fever

Typhus Fever

Typhus fever is a well-known epidemic prone disease. Scroll down to understand the nature, causes, symptoms, and available medication to overcome this condition...
Anuja Marathe Kanhere
This fever is also known as jail fever, since it spreads easily in crowded, unhygienic places such as prisons or jails. The name gets its origins from the Greek word typhos that means haziness, which aptly describes the mental state of a typhus patient. The death toll of typhus victims in the past century has been really high, prompting the US health services to declare typhus to be a bioterrorist. Therefore, it is essential to know all the relevant facts about this fever.
Important Facts
Historical Facts
Typhus has been known to exist since 5th century BC. There were repeated bouts of typhus epidemics during World War I and II. Victims of the Holocaust afflicted by this disease, were killed in huge numbers by the Nazis through usage of gas chambers. The Allied forces used a toxic chemical called DDT to curtail this disease during the war. There have been typhus epidemics in the US, Europe, the Middle East and certain parts of Africa as well. Some well-known victims include Anne Frank and Margot Frank from Amsterdam and Sir Robert Bell, the Lord Chief Baron of the Exchequer.
Nature and Causes
Typhus is caused by a parasite called Rickettsia. However, there are four different subtypes of this disease based on the parasite's sub-species and their carriers. These subtypes are as below:
Type Parasite Carriers
Murine typhus Rickettsia typhi Rats and fleas
Scrub typhus Orientia tsutsugamushi Mites and field rodents
Epidemic typhus Rickettsia prowazekii Lice found on human bodies
Tick or Queensland typhus Rickettsia australis Ticks

The primary causes of this infection are poor hygiene conditions and severe infestation of lice, fleas, and ticks. The disease spreads easily in crowded spaces with dark and filthy atmosphere. Infection can also be caused by exposure to hairy animals like cats, rats, mice, raccoons, and squirrels.
Symptoms
When the Rickettsia parasite enters human body, it causes severe inflammation in human blood vessels. This prevents the blood vessels from supplying blood to body organs. In due course, when sufficient quantity of blood fails to reach the patient's brain, he starts feeling the haziness and there are extreme chances of patients slipping into a coma. Some common symptoms of different versions of typhus are:
  • Murine Typhus: Symptoms include severe joint pain, vomiting, nausea, splitting headache, dry cough, a high fever lasting up to almost 14 days, diarrhea, and abdominal pain. A dull red rash first appears on the torso and later spreads to all parts of the body except the face, the palms and the soles. The rash gradually turns into ugly dark red, green, blue and purple colors.
  • Epidemic Typhus: Symptoms include severe muscle pain, splitting headache, cold and cough, chills and high fever lasting up to almost 14 days, severe joint pain, low blood pressure, delirium, rapid spread of an ugly rash all over the body except on palms and soles. Epidemic typhus patients reports seeing a very hurtful bright light in front of their eyes.
  • Scrub Typhus: Symptoms include severe body pain accompanied by high fever, splitting headache, cough, muscle pain and rapid spread of an ugly-looking rash all over the body. Sometimes, there is a severe liver malfunction leading to gastrointestinal problems as well.
  • Queensland Typhus: Symptoms include an ugly red rash all over the body including palms and soles, pneumonia, blood-shot eyes, enlarged lymph nodes, high fever, splitting headache, infection at the tick bite spot on the body.
All the above versions have rashes in common. Typhus rashes look very similar to the rashes appearing during typhoid fever. As a result, there have been past instances of an erroneous medical diagnosis with doctors prescribing typhoid medication to typhus afflicted patients. A common and easy test helps to differentiate the two diseases. When the spots of a typhoid rash are pressed sharply they seem to disappear but when the spots of a typhus rash are pressed sharply, they never disappear.
Stages of Typhus Fever
A crucial fact about this disease is that it lasts for approximately 14 days. The peak or the worst phase of the disease is usually from the 9th to the 12th day. During this time, the patients are known to suffer from breathing problems, loss of appetite, swelling of lymph nodes, swelling of feet and arms, confusion and palpitation. Patients have reportedly experienced a hurtful bright light in front of their eyes accompanied by a continuous ringing sound in their ears. There is a rapid rise in fever with body temperature soaring to anything between 104 to 106 degrees Fahrenheit. There are extreme chances of patients slipping into a coma and meeting with fatal death at this stage.
If, however, the patient does survive the peak phase and reaches the 13th and 14th day, there are good chances of patient's survival and recovery. The 13th and 14th day of fever are known for rapid fall in the body temperature to the normal 98 degrees Fahrenheit, along with a reduction in the inflammation and body rash.
Prevention and Medication
As the old saying goes, prevention is always better than cure. The preventive measures start with maintenance of personal hygiene and cleanliness of surrounding spaces. Infestation of lice and ticks should be carefully controlled. There is a high chance of spread of lice when normal children play with those with a lice infestation. In such a case, parents need to be alert and keep a tab on lice infestation in their children. If possible, medicated shampoos may be used to get rid of head lice. Avoid encounters with any hairy animals and rat excretions. Maintenance of good sanitation is a must. To ensure riddance from lice, make sure to boil the infested clothing, bedding and linen with insecticides. Do not share personal utility items such as hair brushes and face napkins. Avoid being in crowded places.
A zoologist named Rudolf Weigl from Poland was the first person to develop a typhus vaccine in the early 1900s. Post World War II, further research on typhus has helped develop medication through usage of chloramphenicol, naproxen, ibuprofen, tetracycline, doxycycline, azithromycin, ketoprofen or orudis, narcotic and non-steroidal pain medication. Doctors need to ensure prescribing the consumption of antibiotics a couple of days after the fever subsides.
The United Nations World Health Organization or WHO is making rigorous efforts to eradicate the typhus disease permanently. In the process, better quality and cheaper drugs for typhus cure are being developed.