Typhus

The first reliable description of typhus appears in 1489 AD during the Spanish siege of Baza against the Moors during the War of Granada (1482–1492). These accounts include descriptions of fever; red spots over arms, back, and chest; attention deficit, progressing to delirium; and gangrenous sores and the associated smell of rotting flesh. During the siege, the Spaniards lost 3,000 men to enemy action, but an additional 17,000 died of typhus.[23]

In historical times, "jail fever" or "gaol fever" was common in English prisons, and is believed by modern authorities to have been typhus. It often occurred when prisoners were crowded together into dark, filthy rooms where lice spread easily. Thus, "imprisonment until the next term of court" was often equivalent to a death sentence. Prisoners brought before the court sometimes infected members of the court.[24] The Black Assize of Exeter 1586 was another notable outbreak. During the Lent assizes court held at Taunton in 1730, gaol fever caused the death of the Lord Chief Baron, as well as the High Sheriff, the sergeant, and hundreds of others. During a time when persons were executed for capital offenses, more prisoners died from 'gaol fever' than were put to death by all the public executioners in the British realm. In 1759, an English authority estimated that each year, a quarter of the prisoners had died from gaol fever.[24] In London, gaol fever frequently broke out among the ill-kept prisoners of Newgate Prison and then moved into the general city population. In May 1750, the Lord Mayor of London, Sir Samuel Pennant, and many court personnel were fatally infected in the courtroom of the Old Bailey, which adjoined Newgate Prison.[25]

Epidemics occurred routinely throughout Europe from the 16th to the 19th centuries, including during the English Civil War, the Thirty Years' War, and the Napoleonic Wars.[26] Pestilence of several kinds raged among combatants and civilians in Germany and surrounding lands from 1618 to 1648. According to Joseph Patrick Byrne, "By war's end, typhus may have killed more than 10 percent of the total German population, and disease in general accounted for 90 percent of Europe's casualties."[27]

During Napoleon's retreat from Moscow in 1812, more French soldiers died of typhus than were killed by the Russians.[28]

A major epidemic occurred in Ireland between 1816 and 1819, during the famine caused by a worldwide reduction in temperature known as the Year Without a Summer. An estimated 100,000 people perished. Typhus appeared again in the late 1830s, and yet another major typhus epidemic occurred during the Great Irish Famine between 1846 and 1849. The Irish typhus spread to England, where it was sometimes called "Irish fever" and was noted for its virulence. It killed people of all social classes, as lice were endemic and inescapable, but it hit particularly hard in the lower or "unwashed" social strata.

In the United States, a typhus epidemic broke out in Philadelphia in 1837 and killed the son of Franklin Pierce (14th President of the United States) in Concord, New Hampshire, in 1843. Several epidemics occurred in Baltimore, Memphis, and Washington, DC, between 1865 and 1873. Typhus was also a significant killer during the US Civil War, although typhoid fever was the more prevalent cause of US Civil War "camp fever". Typhoid fever is caused by the bacterium Salmonella enterica Serovar Typhi.[29]

In Canada alone, the typhus epidemic of 1847 killed more than 20,000 people from 1847 to 1848, mainly Irish immigrants in fever sheds and other forms of quarantine, who had contracted the disease aboard the crowded coffin ships in fleeing the Great Irish Famine. Officials neither knew how to provide sufficient sanitation under conditions of the time nor understood how the disease spread.[30]

Typhus was endemic in Poland and several neighboring countries prior to World War I (1914–1918), but became epidemic during the war.[31][32][33] Delousing stations were established for troops on the Western Front during World War I, but typhus ravaged the armies of the Eastern Front, where over 150,000 died in Serbia alone.[34] Fatalities were generally between 10% and 40% of those infected and the disease was a major cause of death for those nursing the sick.

In 1922, the typhus epidemic reached its peak in Soviet territory, with some 20 to 30 million cases in Russia.[35] Although typhus had ravaged Poland with some 4 million cases reported, efforts to stem the spread of disease in that country had largely succeeded by 1921 through the efforts of public health pioneers such as Hélène Sparrow and Rudolf Weigl.[36] In Russia during the civil war between the White and Red Armies, epidemic typhus killed 2–3 million people, many of whom were civilians.[33][35][37][38] In 1937 and 1938 there was a typhus epidemic in Chile.[39]

During World War II, many German POWs after the loss at Stalingrad died of typhus. Typhus epidemics killed those confined to POW camps, ghettos, and Nazi concentration camps who were held in unhygienic conditions. Pictures of mass graves including people who died from typhus can be seen in footage shot at Bergen-Belsen concentration camp.[40] Among thousands of prisoners in concentration camps such as Theresienstadt and Bergen-Belsen who died of typhus[40] were Anne Frank, age 15, and her sister Margot, age 19 in the latter camp.

The first typhus vaccine was developed by the Polish zoologist Rudolf Weigl in the interwar period; the vaccine did not prevent the disease but reduced its mortality.[41]

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  Charles Nicolle received the 1928 Nobel Prize in Medicine for his identification of lice as the transmitter of epidemic typhus.
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  A US soldier is demonstrating DDT hand-spraying equipment. DDT was used to control the spread of typhus-carrying lice.
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  A Civilian Public Service worker distributes rat poison for typhus control in Gulfport, Mississippi, around 1945.

Beginning in 2018, a typhus outbreak spread through Los Angeles County primarily affecting homeless people.[42] In 2019, city attorney Elizabeth Greenwood revealed that she, too, was infected with typhus as a result of a flea bite at her office in Los Angeles City Hall.[43][44] Pasadena also experienced a sudden uptick in typhus with 22 cases in 2018 but, without being able to attribute this to one location, the Pasadena Public Health Department did not identify the cases as an "outbreak".[45]