Typhus fever, characterized by pink spots on the skin, is caused by organisms transmitted by body lice. Several disease are grouped together under the general name “typhus fevers,” because of the similarity of organisms causing them and the fact that these organisms are transmitted by the bites of lice, fleas, ticks, or mites.
The germs of typhus fever are very small, and are related to those of Rocky Mountain spotted fever. Germs of this type are called rickettsiae. Louse-borne typhus is transmitted from person to person by the body louse. Spread of the lice from the body or cloth of one person to those of others is favored by close contact and lack of personal cleanliness, especially in cold weather when warm clothing is worn. Extermination of body lice is the secret of success in preventing typhus fever. Dusting powders developed specially during and following World War-2 proved very effective.
Shortly before the symptoms appear, the typhus victim may seem to have a common cold. The real onset of the disease is sudden, with chills, high fever, headache, general pains, prostration, nausea, vomiting, constipation or diarrhea, with possible delirium or stupor developing early. About the fifth day small pink spots appear on the skin, changing to red, then purple, and finally a brownish color. There is usually bronchitis with cough and sputum. The pulse is rapid, but blood pressure is low.
Typhus is not a serious disease among young persons, but among the elderly it may be deadly. Mortality has run from 4 percent to as high as 70 percent, depending on age and locality; but with modern remedies the prospect is brighter.
What to Do:
1. For the surety of the attendant and others, be sure that no living lice are left others, be sure that no living lice are left on the victim’s body. Cover the victim’s body and sterilize his clothing, preferably by heat.
2. Since dried louse feces may contain living typhus germs, attendants should wear masks, goggles, gloves, and protective gowns.
3. Chloromycetin, the tetracycline antibiotics, and other effective remedies must be ordered or given by a physician.
4. Before attending a typhus, victim, or before visiting a typhus region, it is advisable to be vaccinated against the disease.
Flea Typhus and Tick Typhus:
During recent years a mild type of typhus fever, sometimes called endemic typhus, flea typhus, or murine typhus, has become increasingly prevalent, a rising incidence usually accompanying an increase in the rat population. Most cases are spread by rat fleas, not lice. While the disease is seldom fatal, the control problem is difficult. It is virtually impossible to exterminate the fleas that carry it. They do not stay on the body, in the clothing, or even always in the house of the victim; and there is no way of fumigation the outdoors. Rat extermination, however, is a valuable control measure.
Tick-borne typhus fevers occur in many tropical countries. The infected ticks found on dogs will occasionally bite humans. In removing ticks from dogs in such regions, it is wise to use forceps or a piece of paper rather than bare fingers.
Also Read: What is Dengue Fever? Symptoms and Treatment
What to Do:
1. Secure the service of a physician, if possible. The same remedies that are useful in cases of epidemic typhus (see above) should be used in flea typhus or tick typhus.
The rickettsial organisms that case scrub typhus are transmitted by numerous species of mites. They can pick up or transmit the organisms only in their larval or blood-sucking stage, but they carry them in their bodies until maturity and pass them on to the next generation of mites through the eggs. Rodents may act as reservoirs of infection.
In a typical case, a painless papule first appears, usually on some part of the body ordinarily covered by clothing. It enlarges and becomes dark in the center, eventually forming an ulcer less than half an inch in diameter that leaves a scar when it heals. Lymph nodes in its vicinity swell and become tender.
As the disease develops there is a gradually rising fever. The pulse rate is slower than might be expected. In many cases, but not all, a body rash appears about the fifth day, spreads widely, and lasts from one to ten days. The spleen is enlarged and tender. At the height of the disease severe headache behind the eyes, loss of appetite, nausea, vomiting, muscular twitching, difficult breathing, cough, deep prostration, and delirium may occur. Without specific treatment up to 10 percent of the victims die.
What to Do:
1. Follow the instructions given for epidemic typhus (see above), except for louse-extermination measures.
2. Keep the victim from returning to regular work until long after convalescence seems complete. Heart damage may be present.
3. As preventive measures follow these procedures:
4. As far as possible, avoid mite-in-fasted localities.
5. Try to clear away or burn vegetation infested by mites.
6. Wear clothing that will keep the mites from gaining access to the skin (close-woven fabrics, long pants, leggings, long sleeves, tight collars, and tight wristbands).
7. Apply a thin layer of proved insect repellent to parts of the clothing which mites must pass in order to reach the skin.