1. Epidemic typhus Murine typhus Scrub typhus Human Louse Mite

2. Rickettsia Prowazekii Obligate intracellular bacteria Pleiomorphic rods Susceptible to moist heat and dry heat

3. Cases reported in the world since 1997

5. Symptoms Acute infection Brill-Zinsser disease

6. Diagnosing Epidemic Typhus Clinical signs and history (for initial diagnosis) Confirmatory diagnosis ◦ Culture ◦ Serology ◦ Biopsy ◦ PCR

7. Epidemic typhus found in Houston, Texas 176 participants ◦ 2 had antibodies against R. prowazekii ◦ 17 had antibodies against R. typhi Reeves et al. (2008)

8. Treatment and Prevention Delousing Antibiotics ◦ Chloramphenicol ◦ Tetracycline  Doxycycline 200 mg Vaccine not commercially available

9. High prevalence of Typhus during wartime

10. References www.who.int/ith/diseases/typhusfever/en/ www.nlm.nih.gov/medlineplus/ency/article/001363.htm www.textbookofbacteriology.net/Rickettsia_2.html www.inkling.com/read/rubins-pathology-emanuel-rubin- 6th/chapter-9/epidemic-louse-borne-typhus www.uptodate.com/contents/epidemic- typhus/abstract/2?utdPopup=true vb3lk7eb4t.search.serialssolutions.com/?sid=Entrez:PubMed& id=pmid:18697325 entomology.montana.edu/historybug/typhus-conlon.pdf http://dx.doi.org/10.3376/1081- 1710(2008)33[205:SEOTGR]2.0.CO;2

11. Research The genome sequence of Rickettsia prowazekii and the origin of mitochondria The genome sequence of Rickettsia prowazekii and the origin of mitochondria ◦ 1998 Serological evidence of typhus group rickettsia in a homeless population in Houston, Texas Serological evidence of typhus group rickettsia in a homeless population in Houston, Texas ◦ 2008 Cluster of Sylvatic Epidemic Typhus Cases Associated with Flying Squirrels, 2004–2006 Cluster of Sylvatic Epidemic Typhus Cases Associated with Flying Squirrels, 2004–2006 ◦ 2009 ◦ http://vb3lk7eb4t.search.serialssolutions.com/?sid= Entrez:PubMed&id=pmid:806809 http://vb3lk7eb4t.search.serialssolutions.com/?sid= Entrez:PubMed&id=pmid:806809 ◦ http://www.ajtmh.org/content/27/2/339 http://www.ajtmh.org/content/27/2/339