Epidemic typhus is one of the oldest diseases known to affect humankind, and despite advances in modern medicine, it continues to be a contemporary concern. Often infiltrating human existence hand in hand with disasters such as war and weather phenomena, typhus has demonstrated a potential to change the course of history and dictate decision-making. It has wreaked havoc, been used as a weapon, and traumatized generations on a global scale. Check out the surprising impacts that typhus has had on the history of the world over the centuries.
Background & Context: Spotted Fever
Typhus, not to be confused with typhoid or typhoid fever, is a bacterial disease that is generally spread by body lice. The bacteria are introduced to the human body when a louse bites, or when infected lice feces are scratched into the skin. Inhaling dust that contains contaminated lice or their body products can cause the spread of infection as well.
Symptoms of typhus include a high fever, confusion leading to delirium, cough, severe muscle and joint pain, low blood pressure, sensitivity to light, and severe headache. A hallmark symptom is a rash that begins on the chest and has the potential to spread all over the body, with the exception of the soles of the feet and palms of the hands. This rash has led to an inability to differentiate between smallpox and typhus among many historical accounts of disease epidemics.
Numerous strains of related bacteria cause various typhus diseases, but the type spread by lice, sometimes known as epidemic typhus or spotted fever, is caused by Rickettsia prowazekii. Scrub typhus (orienta tsutsugamushi), common in Southeast Asia, is spread by chigger bites, while Murine or flea-borne typhus (Rickettsia typhi) is spread by the bites of fleas. Other Rickettsia diseases include Rocky Mountain Spotted Fever, African Tick Bite Fever, and Rickettsialpox. Today, typhus is generally curable if the patient is properly diagnosed, and rendered harmless with antibiotic treatment. Death is possible, but rare in contemporary infections.
1. The Plague of Athens Was Perhaps the 1st Recorded Typhus Epidemic
Although due to “plague” terminology, many assume that the Plague of Athens was caused by the Bubonic Plague, modern science does not know with certainty which pathogen wreaked havoc on the Greek city-state from 430-426 BCE. However, contemporary historians and medical experts have debated the topic extensively, and many have concluded that the descriptions of the epidemic align with that of a typhus outbreak.
The plague struck when Athens was at a vulnerable point in its history; it was under siege by Sparta as part of the Peloponnesian War. The epidemic of disease would last over the next several years, infecting most of the city’s population at some point. An estimated quarter of the Athenian citizenry would perish, including famed statesman Pericles.
The epidemic was detailed in writing by Thucydides, a historian and military man, who wrote about the despair and destruction he observed around him. Based on his writings, it is clear that the disease was likely vector-borne and attacked people of all ages and both sexes—putting typhus on the list of definite possibilities.
2. It May Have Allowed the British to Take New York in the Revolutionary War
In August 1776, General Nathanael Greene, a key player in the Continental Army during the Revolutionary War, was incapacitated by a brutal illness that had been ravaging his ranks. Sanitation in the camp had been noted to be especially poor in the General’s reports. The illness led Nathanael Greene and his forces to be absent from the Battle of Long Island (also known as the Battle of Brooklyn). This would turn out to be the biggest battle of the Revolutionary War and a crushing defeat for the Patriot cause.
Israel Putnam was named as Greene’s replacement and is considered by history to be a less capable soldier than the competent Greene was. Putnam is blamed for leaving a critical path unguarded during the battle, allowing British access and perhaps changing the course of the battle’s outcome.
3. Typhus Took Out Much of Napoleon’s Army
In June 1812, prominent French General Napoleon Bonaparte marched at the head of what was christened his Grande Armée, made up of what is estimated to be approximately half a million men. Their destination was Moscow, to engage with and subdue the Russian army. Within six months, Napoleon would find himself limping back to France, with more than 300,000 men lost—though not as a result of fighting with the Russians. The majority of the Grande Armée’s losses would come as the result of a typhus epidemic, one that they would carry back with them across Europe on their return home.
As the men marched their way back to France, epidemic typhus came with them, spreading and causing several outbreaks in Germany especially. The failure of this campaign resulted in Napoleon’s public shaming and his first exile.
4. Typhus Devastated the Eastern Front in WWI
During World War I, typhus wreaked devastation on the Eastern front in Europe. Despite remarkable medical progress that had been achieved since the American Civil War when it came to understanding and diagnosing disease, medicine was no match for epidemic typhus in wartime. Over 200,000 people in Serbia, soldiers, prisoners, and citizens alike, perished from typhus during a 6-month span at the start of the conflict, with a climbing mortality rate as the war progressed. Doctors and hospitals were overburdened and helpless.
Typhus would continue to be a scourge in the East but never spread to the Western front. Incredible measures were implemented to prevent it, with some historians stating that soldiers on both sides were more afraid of typhus as they were of being shot or shelled—and with good reason. Delousing and sanitation programs were implemented across Europe to protect soldiers, particularly those moving in and out of the trenches, where lice were endemic.
5. Typhus Was Used to Sabotage the Nazis in WWII
Between the two world wars, Polish microbiologist Rudolf Weigl was hard at work in his lab, which had become a world center of typhus research. His work was incredibly innovative, functioning on the tiniest of scales, using lice as experimental subjects. He became the first scientist to culture Rickettsia bacteria, by separating it from a louse. Weigl used the lice in his work to create the first reliable typhus vaccine, which he was testing and distributing in the 1930s.
Nazi propaganda associated lice with Jews, and as World War II progressed, German soldiers began moving into areas that had suffered from typhus outbreaks before or where troops feared typhus was lurking. As Germany took control of Poland, and in turn Weigl’s lab, in 1941, the scientist was ordered to develop and produce a typhus vaccine for the German army.
This assignment allowed Weigl’s lab to become a safe haven for some of the locals. His work required volunteers to blood-feed the lice with which he would create vaccines. Weigl would strap small boxes of lice to the volunteers, many of them Jewish, which allowed them to earn a small income for their work and gave them added protection from the Nazis and circulating looters, who wanted nothing to do with “lice-ridden” people or their homes.
Existing in a world of constant tension with the Nazi occupiers, Weigl managed to ferret away a small amount of vaccine for use among his neighbors and citizens in the local ghettos and also created some batches of suboptimal vaccine to pass on to the German army.
Weigl’s former assistant, Ludwik Fleck, was charged with creating a similar lab in the Lwów ghetto. He was arrested in 1943 and sent to work in labs at Auschwitz and then Buchenwald. In his work there, he and his team claimed to be culturing bacteria in experimental animals, such as rabbits, to use in the manufacture of vaccines.
While the resulting substance was useless, the Nazis didn’t know that. Fleck was able to survive working for the enemy with subtle sabotage. At the same time, he was able to make small batches of effective vaccines to distribute among camp inmates, who were suffering under horrible sanitary conditions, potentially saving lives.
6. Typhus Still Exists Today in the 21st Century
Believe it or not, typhus remains at large in the world today, despite progress in medical care. Today, it is most prevalent in areas with large homeless or impoverished populations, refugee camps, or areas experiencing natural disasters or war. Outbreaks are more common during colder months when more people are indoors and clothes may not be laundered as frequently. However, the overall number of global cases has dropped significantly over the centuries as hygiene and sanitation have improved.
In the United States, the Los Angeles area has made the news in recent years for typhus outbreaks. These cases have been attributed to the conditions in which the homeless population lives. In a city where over 75,000 are estimated to be without a place to sleep on any given night, typhus only adds to the list of concerns for the unhoused population. However, typhus has affected those across the spectrum of wealth and privilege in LA, even making its way into city hall and infecting a city attorney and other employees. Some health officials argue that the homelessness issue and the typhus problem are separate concerns, attributing the outbreaks to wildlife interactions.
Though Weigl’s work in the World War II era produced an effective typhus vaccine, that preventative measure is no longer in production today. Due to the general worldwide decrease in epidemic typhus, the vaccine is no longer manufactured. Instead, preventative measures are encouraged, such as maintaining adequate personal hygiene when possible, avoiding travel to regions that are high risk or where outbreaks have recently occurred, and prophylactic antibiotics at a doctor’s discretion.
