Epidemic Typhus Imported from Algeria

Reemerging Threat of Epidemic Typhus in Algeria

“…In Algeria, a large typhus outbreak occurred during World War II (6), and subsequently the disease was endemic until 1970 (9). After that date, no case was reported in this country until 1999, when we reported the case of an Algerian patient who had been diagnosed as having epidemic typhus on returning from travel to Msila, a town in the highlands of eastern Algeria (13). In the present report, our patient also contracted typhus in a mountainous area of eastern Algeria close to Msila.…”

“…In addition, a recrudescent and attenuated form of the disease (Brill-Zinsser disease) may occur up to 40 years post acute infection and serve as the source of future outbreaks (20). Although the disease is mainly prevalent in the highland and colder areas of Africa, Asia, and Central and South America (15,16,22), small outbreaks or sporadic cases of epidemic typhus have been described in industrialized countries (10,11,13,21). R. prowazekii, which is currently on the B list of potential bioterrorism agents maintained by the U.S. Centers for Disease Control and Prevention, is transmitted to humans by Pediculus humanus humanus, the human body louse, which is infected while feeding on the blood of infected patients.…”

Potential role of head lice, Pediculus humanus capitis, as vectors of Rickettsia prowazekii

“…In a Peruvian study, , again body lice were collected and tested for R. prowazekii, but not head lice. An interesting case occurred in 1998, when a man returning from Algeria to France developed louse-borne typhus (Niang et al 1999). No evidence of body lice was found but he did recall having pruritus of the scalp and scratching during his stay in Algeria (Niang et al 1999).…”

Rickettsiosis as Threat for the Traveller

“…In severe cases mainly associated with epidemic typhus, evolution to a multiple-organ dysfunction syndrome and coagulation disorders may appear. Some references related to travellers are: Zanetti et al, 1998;Niang et al, 1999;Kelly et al, 2002;Jensenius et al, 2004;Azuma et al, 2006;Angelakis et al, 2010;Walter et al, 2011. …”