ArtsAutosBooksBusinessEducationEntertainmentFamilyFashionFoodGamesGenderHealthHolidaysHomeHubPagesPersonal FinancePetsPoliticsReligionSportsTechnologyTravel

Epidemic Typhus (Louse-Borne Typhus): Pathology, Clinical Manifestations, Diagnosis, Treatment And Prevention

Updated on March 25, 2014

General Symptoms Of Epidemic Typhus


A General Overview On Epidemic Typhus

Epidemic typhus is a severe febrile disease caused by Rickettsia prowazekii. Man is the only known host for this parasite. As age advances the disease assumes more serious proportions. Several epidemics have occurred during famine, war and other natural calamities, when people had to be kept in camps under unhygienic conditions.

Rickettsia prowazakii is transmitted by the body louse (Pediculus humanus corporis) and rarely the head louse (Pediculus humanus capitis) from man to man. The lice are infected by the blood meal. An infected louse passes the organisms in feces for the rest of its life (4 weeks). When the patient scratches, the lice are crushed and their body contents are smeared on to the bite wound through which organisms enter the host. Inhalation of the dried lice feces is another possible mode of entry. Lice leave dead bodies to sek new hosts and in this process they spread infection. Persons who suffer from typhus acquire lifelong immunity. In some cases, relapse occurs after a long latent period and this is referred to as Brill- Zinsser’s disease. Occasionally, epidemics have followed such sporadic cases.

Pathology: Pathologically, the lesions are characterized by angitis seen in the small blood vessels of various organs including the skin, heart, skeletal musucles and brain. The blood vessels are thrombosed or they may rupture. Rickettsiae are seen in the proliferated endothelial cells. Various tissues show infiltration by round cells, macrophages, and sometimes lymphocytes and plasma cells. The vascular changes lead to patchy gangrene of the skin, sloughing of the skeletal muscles and myocarditis.

Epidemic Typhus In Burundi


Clinical Manifestations And Treatment Of Epidemic Typhus

Clinical Manifestations

Average incubation period is 7 days (5 to 21 days). Fever is sudden in onset with malaise and myalgia. Temperature rises to 39 to 400C and remains continuous. The face is flushed, conjunctiva is injected and there is severe sore throat. A macular skin rash appears on the fifth day. It is particularly seen in the axilla, abdomen, chest, back and extremities. The rash starts to fade by about the tenth day. Involvement of the central nervous system leads to headache, stupor, coma and urinary incontinence. Bleeding from the mucous membranes gives rise to hematemesis, epistaxis, melena and hematuria. Respiratory involvement leads to bronchitis, bronchopneumonia, lung abscess or gangrene of the lung. Myocardial involvement is manifested by tachycardia, hypotension and cardiac failure. In uncomplicated cases, the temperature comes down by the twelfth to fourteenth day by lysis.

Complications include patchy gangrene of the skin over the extremities, parotitis, cardiac failure, and renal failure. Death may occur in the latter part of the second week due to complications. Though the disease used to be associated with high mortality during the epidemics, early diagnosis and specific therapy have considerably lowered the mortality rate.

Diagnosis: The disease has to be diagnosed by the clinical features. Epidemic typhus has to be differentiated from typhoid, malaria, tuberculosis, pneumonia, relapsing fever and other rickettsial diseases. Laboratory diagnosis is by the Weil- Felix reaction and other specific tests including isolation of the organisms. The organisms can be isolated from blood collected during the early phase of the illness.


Chloramphenicol and tetracyclines are specific and highly effective, when given in a dose of 2 to 4 kg daily. They have to be continued for a week after the temperature reaches normal to avoid relapse.

Prevention: On admission to the wards, the clothes of the patient should be disinfected by heat or 10% DDT or 1% Lindane powder. Personal prophylaxis may be achieved by vaccination. Vaccines containing either killed rickettsiae (Cox vaccine) or live avirulent strains are available.

© 2014 Funom Theophilus Makama


    0 of 8192 characters used
    Post Comment

    No comments yet.


    This website uses cookies

    As a user in the EEA, your approval is needed on a few things. To provide a better website experience, uses cookies (and other similar technologies) and may collect, process, and share personal data. Please choose which areas of our service you consent to our doing so.

    For more information on managing or withdrawing consents and how we handle data, visit our Privacy Policy at:

    Show Details
    HubPages Device IDThis is used to identify particular browsers or devices when the access the service, and is used for security reasons.
    LoginThis is necessary to sign in to the HubPages Service.
    Google RecaptchaThis is used to prevent bots and spam. (Privacy Policy)
    AkismetThis is used to detect comment spam. (Privacy Policy)
    HubPages Google AnalyticsThis is used to provide data on traffic to our website, all personally identifyable data is anonymized. (Privacy Policy)
    HubPages Traffic PixelThis is used to collect data on traffic to articles and other pages on our site. Unless you are signed in to a HubPages account, all personally identifiable information is anonymized.
    Amazon Web ServicesThis is a cloud services platform that we used to host our service. (Privacy Policy)
    CloudflareThis is a cloud CDN service that we use to efficiently deliver files required for our service to operate such as javascript, cascading style sheets, images, and videos. (Privacy Policy)
    Google Hosted LibrariesJavascript software libraries such as jQuery are loaded at endpoints on the or domains, for performance and efficiency reasons. (Privacy Policy)
    Google Custom SearchThis is feature allows you to search the site. (Privacy Policy)
    Google MapsSome articles have Google Maps embedded in them. (Privacy Policy)
    Google ChartsThis is used to display charts and graphs on articles and the author center. (Privacy Policy)
    Google AdSense Host APIThis service allows you to sign up for or associate a Google AdSense account with HubPages, so that you can earn money from ads on your articles. No data is shared unless you engage with this feature. (Privacy Policy)
    Google YouTubeSome articles have YouTube videos embedded in them. (Privacy Policy)
    VimeoSome articles have Vimeo videos embedded in them. (Privacy Policy)
    PaypalThis is used for a registered author who enrolls in the HubPages Earnings program and requests to be paid via PayPal. No data is shared with Paypal unless you engage with this feature. (Privacy Policy)
    Facebook LoginYou can use this to streamline signing up for, or signing in to your Hubpages account. No data is shared with Facebook unless you engage with this feature. (Privacy Policy)
    MavenThis supports the Maven widget and search functionality. (Privacy Policy)
    Google AdSenseThis is an ad network. (Privacy Policy)
    Google DoubleClickGoogle provides ad serving technology and runs an ad network. (Privacy Policy)
    Index ExchangeThis is an ad network. (Privacy Policy)
    SovrnThis is an ad network. (Privacy Policy)
    Facebook AdsThis is an ad network. (Privacy Policy)
    Amazon Unified Ad MarketplaceThis is an ad network. (Privacy Policy)
    AppNexusThis is an ad network. (Privacy Policy)
    OpenxThis is an ad network. (Privacy Policy)
    Rubicon ProjectThis is an ad network. (Privacy Policy)
    TripleLiftThis is an ad network. (Privacy Policy)
    Say MediaWe partner with Say Media to deliver ad campaigns on our sites. (Privacy Policy)
    Remarketing PixelsWe may use remarketing pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to advertise the HubPages Service to people that have visited our sites.
    Conversion Tracking PixelsWe may use conversion tracking pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to identify when an advertisement has successfully resulted in the desired action, such as signing up for the HubPages Service or publishing an article on the HubPages Service.
    Author Google AnalyticsThis is used to provide traffic data and reports to the authors of articles on the HubPages Service. (Privacy Policy)
    ComscoreComScore is a media measurement and analytics company providing marketing data and analytics to enterprises, media and advertising agencies, and publishers. Non-consent will result in ComScore only processing obfuscated personal data. (Privacy Policy)
    Amazon Tracking PixelSome articles display amazon products as part of the Amazon Affiliate program, this pixel provides traffic statistics for those products (Privacy Policy)