title: A clinico-epidemiological study of epidemic typhus in Africa.
abstract: Epidemic, louse-borne typhus persists in the rugged, mountainous areas of Ethiopia and much of northeastern and central Africa as well as in the rural highlands of Central and South America, where the conditions of living favor the harboring of body lice and where antibiotic treatment and effective louse-control measures are unavailable. The historical significance and current epidemiology of typhus, including the reservoir of Rickettsia prowazekii in flying squirrels in the United States, are reviewed, and the clinical presentation, laboratory findings, and hospital course in the cases of 60 patients admitted with epidemic, louse-borne typhus to the St. Paul's Hospital in Addis Ababa, Ethiopia, are described. Treatment of this disease with oral doxycycline, tetracycline, or chloramphenicol prevents complications and results in prompt resolution of symptoms.
authors.affiliation: Department of Preventive Medicine and Biometrics (Division of Tropical Public Health), Uniformed Services University of the Health Sciences, Bethesda, Maryland 20814-4799.
authors.forename: P L
authors.initials: PL
authors.lastname: Perine
authors.forename: B P
authors.initials: BP
authors.lastname: Chandler
authors.forename: D K
authors.initials: DK
authors.lastname: Krause
authors.forename: P
authors.initials: P
authors.lastname: McCardle
authors.forename: S
authors.initials: S
authors.lastname: Awoke
authors.forename: E
authors.initials: E
authors.lastname: Habte-Gabr
authors.forename: C L
authors.initials: CL
authors.lastname: Wisseman
authors.forename: J E
authors.initials: JE
authors.lastname: McDade
mesh_terms: D000293:Adolescent; D000328:Adult; D000349:Africa / Q000453:epidemiology; D000818:Animals; D001773:Blood Cells; D001774:Blood Chemical Analysis; D004196:Disease Outbreaks; D004197:Disease Reservoirs; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012283:Rickettsia prowazekii / Q000302:isolation & purification*; D012589:Sciuridae; D014438:Typhus, Epidemic Louse-Borne / Q000097:blood / Q000453:epidemiology* / Q000652:urine; D014556:Urine / Q000737:chemistry / Q000166:cytology