THE Typhoid, and Dysentery, it is known to

THE
HISTORICAL ACCOUNT OF EPIDEMIC TYPHUS

INTRODUCTION

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Louse
borne typhus is one of the oldest pernicious diseases, that has been haunting
mankind. Known by the many names such as “camp fever”, “war fever”, “jail
fever” and “tabarillo” and confused with many other fevers and diseases, it was
only in the late 15th century, it was identified as a cause of major
epidemics. With Plague, Typhoid, and Dysentery, it is known to have wiped out armies
and civilian populations from the 15th to the 20th century, playing a decisive
role in the fate of wars in Europe. This paper will attempt to further analyse  the historical impact of Louse-borne Typhus
and how its epidemic propagation has led many to regard Pediculus humanus
corporis to have a more remarkable influence on human history than any
other parasite.

EPIDEMIC
TYPHUS FEVER (TABARILLO, CLASSIC OR EUROPEAN TYPHUS, JAIL FEVER, WAR FEVER)

The
denomination “typhus” was derived from the Greek word typhos, meaning
“smoke” resembling the
delirious state, that one suffers from, during infection. Originally,
“typhus” represented any of the self-limiting fevers accompanied by
stupor. In 1829, the French clinician Louis demarcated ‘Typhus Fever’ from
‘Typhoid Fever’.

 Causative Agent and transmission : Epidemic Typhus, as isolated and identified by
DaRocha-Lima in 1916, is caused by small
Gram-negative coccobacilli-shaped bacteria, Rickettsia prowazeki, that
was originally believed to be a virus because of its minute size and
difficulty of cultivation. being an obligate intracellular
parasite, it utilizes the components within the cell to survive and multiply.
It was named in honor of H. T. Ricketts and L. von Prowazek, who in the course
of their investigations died of infection. The cell wall being excessively permeable
to many large metabolites accounts for the microorganism’s requirement for a
living host. The host is believed to supply ATP, NAD, and CoA. (Brezina et al.,
1973).

Transmission
of Epidemic Typhus is through the body louse (Pediculus humanus corporis) faeces contaminated with R. prowazekii. Louse bite, causes itching and scratching , which allows the bacteria to enter
the scratch or bite area through the skin. Indirect person-to-person transmission
may occur if the lice infects one person, who then develops the disease and the
then infected lice moves from person to person by bites and defaecation or via
shared clothing between individuals.

SIGNS AND SYMPTOMS : After an incubation period of 7-14 days, fever, headache,
and prostration occur suddenly. Temperature shoots up to 40° C in several
days, with slight morning remission, for nearly 2 weeks. Headache is intense.
Small, pink macules, appear on the 4th to 6th day and rapidly cover the body,
usually in the axillae and on the upper trunk excluding the palms, soles, and
face. Later, the rash becomes dark and maculopapular. the rash becomes
petechial and hemorrhagic, in extreme cases. Splenomegaly occurs at times.

Epidemic Propagation:
Propagation is regulated in human populations by the circulation of lice
between individuals. The louse is a comparatively an inefficient vector, due to
short range of movement; it crawls and cannot fly. moreover, as the active
stages survive only for 7-10 days without a suitable host upon which to feed
and accompanied by  the fact that they
are exclusively human parasites. The epidemic spread is hence favoured by the
existence of a large louse population on humans who are crowded together in
their living quarters. Scratching and itching on the part of heavily infested
individuals causes lice to move to the outer surface of clothing and be readily
transferred to others. Thus, in crowded tenements, jails, refugee camps, or
times of war or disaster, when prisoners, refugees, or soldiers are unable to
change clothes or bath regularly, lice spreads quickly within the entire
population. Especially during the winter, when bathing is made more difficult
due the chilled weather. Thus, in centuries and areas where overcrowding, malnourishment,
and lack of sanitation were prevalent, typhus spread rapidly.

 

THE
HISTORICAL IMPACT OF EPIDEMIC TYPHUS:

The Fifteen Century.The first record of epidemic typhus in history, was in 1489 during the
Spanish inquisition and Reconquista. Louse-borne typhus epidemic broke out
within the Spanish army killing over 17,000 soldiers within a month out of
which only 3,000 men had died in actual combat. Typhus, completely destructed
the Spanish army allowing the Moors to maintain their stronghold in
Granada. 

The Seventeenth Century: The Thirty Years War  (1618-1648) was also impacted tremendously after
its introduction to Typhus  during the
first 15 years of the war. Along with Plague, typhus was responsible for the death
of 10,000,000 soldiers, compared to merely 350,000 men who died in combat and was
also responsible for preventing a battle. In 1632 the armies of the Swedish
King Gustavos Adolphus and the Catholic army commander Baron Von Wallenstein

The Nineteenth Century: The 1812 campaign of Napoleon Bonaparte, against the
Russians, remains the classic example. Napoleon’s Grand Armee, originally had
over 600,000 tactful soldiers, marching their way with little resistance to
take over Russian province. Despite the warnings of his medical teams, he
argued that his men could withstand the bitterest of Russian winters- which
turned out to be a fatal mistake.  As the troops marched on, food and
resources began to dwindle, forcing soldiers to rampage the peasantry who were
beset with diseases. This resulted in Epidemic Typhus being brought into the
camps along with the returning troops. The consequences were detrimental;
more than 80,000 French soldiers died within the first month of the
epidemic. Weakening the morale of soldiers. Only 90,000 French soldiers
reached Moscow out of the original army of 600,000.  The majority, as
high as 300,000, had died of Epidemic Typhus and dysentery with combat losses
amounting to less than even 100,000. With this drastic losses and the Russian
policy of Scorched Earth Plan, Napoleon was forced to retreat.