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June 12, 1981, Vol 245, No. 22 >
ARTICLE | June 12, 1981

Epidemic Typhus in the United States Associated With Flying Squirrels FREE

Richard J. Duma, MD, PhD; Daniel E. Sonenshine, PhD; F. Marilyn Bozeman; James M. Veazey, Jr, MD; Bennett L. Elisberg, MD; Douglas P. Chadwick; Naomi I. Stocks; Thomas M. McGill; Grayson B. Miller, Jr, MD; J. Newton MacCormack, MD, MPH
[+] Author Affiliations

Reprint requests to Division of Infectious Diseases, Medical College of Virginia, Virginia Commonwealth University, MCV Station, PO Box 49, Richmond, VA 23298 (Dr Duma).


JAMA. 1981;245(22):2318-2323. doi:10.1001/jama.1981.03310470032022
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References

Between July 1977 and January 1980, seven cases of sporadic, nonepidemic "epidemic" typhus (Rickettsia prowazekii) were discovered in Virginia, West Virginia, and North Carolina. The reservoir seemed to be the southern flying squirrel (Glaucomys volans), an animal indigenous to the eastern United States; however, the vector or mode of acquisition was not evident. Diagnosis was established principally through complement fixation, indirect immunofluorescence, and toxin neutralization tests. Patients' ages were 11 to 81 years. Most were white women. Six had abrupt onset of illness. Headaches, fever, myalgias, and exanthems were among the presenting complaints. The disease seemed milder than classic louse-born epidemic typhus, but in some instances, it was life-threatening. All patients responded to tetracycline or chloramphenicol. This entity probably is more common than reported, is difficult to recognize, and is produced by an organism seemingly identical to that producing louse-born epidemic typhus.

(JAMA 1981;245:2318-2323)

REFERENCES

1 +
Tarrizo ML:  Geographic distribution of louse-borne diseases , in The Control of Lice and Louse Borne Diseases , scientific publication No. 263. Washington, DC, Pan American Health Organization, 1973;, pp 50-59.
2 +
Ormsbee R, Peacock M, Philip R, et al:  Antigenic relationships between the typhus and spotted fever groups of rickettsiae . Am J Epidemiol 1978;;108:53-59.
3 +
Bozeman FM, Elisberg BL, Humphries JW, et al:  Serologic evidence of Rickettsia canada infection in man . J Infect Dis 1970;;121:367-371.
4 +
Bozeman FM, Masiello SA, Williams MS, et al:  Epidemic typhus rickettsiae isolated from flying squirrels . Nature 1975;;255:545-547.
5 +
Bozeman. FM, Williams MS, Stocks NI, et al:  Ecologic studies on epidemic typhus infection in the southern flying squirrel , in Kazar J (ed): Proceedings of the Second International Symposium on Rickettsiae and Rickettsial Diseases , Bradislava, Czechoslovakia, Vedo Publishing House of the Slovak Academy of Sciences, 1978;, pp 493-504.
6 +
Woodman DR, Weiss E, Dasch GA, et al:  Biological properties of Rickettsia prowazekii strains isolated from flying squirrels . Infect Immunol 1977;;16:853-860.
7 +
Dasch GA, Samms JR, Weiss E:  Biochemical characteristics of typhus group rickettsiae with special attention to Rickettsia prowazekii strains isolated from flying squirrels . Infect Immunol 1978;;19:676-685.
8 +
Myers WF, Wisseman CL Jr:  Genetic relatedness among the typhus group of rickettsiae . Int J Systemic Bacteriol 1980;;30:143-150.
9 +
Veazey JM Jr, Bozeman FM, Sonenshine DE, et al:  Indigenous acquisition of epidemic typhus in the eastern United States . Read before the 19th Interscience Conference on Antimicrobial Agents and Chemotherapy. Boston, Oct 4, 1979 .
10 +
Veazey JM Jr, Duma RJ, Sonenshine D, et al:  Evidence for indigenous epidemic typhus in Virginia . Va Med 1979;;106:79.
11 +
McDade JE, Shepard CC, Redus MA, et al:  Evidence of Rickettsia prowazekii infections in the United States . Am J Trop Med Hyg 1980;; 29:277-284.
12 +
Reed LJ, Muench H:  A simple method of estimating 50% endpoints . Am J Hyg 1938;; 27:493-497.
13 +
Sonenshine DE, Bozeman FM, Williams MS, et al:  Epizootiology of epidemic typhus (Rickettsia prowazekii) in flying squirrels . Am J Trop Med Hyg 1978;;27:339-349.
14 +
Gerhard WW:  On the typhus fever . Am J Med Sci 1837;;19:289-292.
15 +
Hamilton HL:  Specificity of the toxic factors associated with the epidemic and the murine strains of typhus rickettsiae . Am J Trop Med 1945;;25:391-395.
16 +
Henderson RG, Topping NH:  Epidemic typhus fever: Neutralization of the toxic substance . NIH Bull 1945;;183:41-56.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Tarrizo ML:  Geographic distribution of louse-borne diseases , in The Control of Lice and Louse Borne Diseases , scientific publication No. 263. Washington, DC, Pan American Health Organization, 1973;, pp 50-59.
2 +
Ormsbee R, Peacock M, Philip R, et al:  Antigenic relationships between the typhus and spotted fever groups of rickettsiae . Am J Epidemiol 1978;;108:53-59.
3 +
Bozeman FM, Elisberg BL, Humphries JW, et al:  Serologic evidence of Rickettsia canada infection in man . J Infect Dis 1970;;121:367-371.
4 +
Bozeman FM, Masiello SA, Williams MS, et al:  Epidemic typhus rickettsiae isolated from flying squirrels . Nature 1975;;255:545-547.
5 +
Bozeman. FM, Williams MS, Stocks NI, et al:  Ecologic studies on epidemic typhus infection in the southern flying squirrel , in Kazar J (ed): Proceedings of the Second International Symposium on Rickettsiae and Rickettsial Diseases , Bradislava, Czechoslovakia, Vedo Publishing House of the Slovak Academy of Sciences, 1978;, pp 493-504.
6 +
Woodman DR, Weiss E, Dasch GA, et al:  Biological properties of Rickettsia prowazekii strains isolated from flying squirrels . Infect Immunol 1977;;16:853-860.
7 +
Dasch GA, Samms JR, Weiss E:  Biochemical characteristics of typhus group rickettsiae with special attention to Rickettsia prowazekii strains isolated from flying squirrels . Infect Immunol 1978;;19:676-685.
8 +
Myers WF, Wisseman CL Jr:  Genetic relatedness among the typhus group of rickettsiae . Int J Systemic Bacteriol 1980;;30:143-150.
9 +
Veazey JM Jr, Bozeman FM, Sonenshine DE, et al:  Indigenous acquisition of epidemic typhus in the eastern United States . Read before the 19th Interscience Conference on Antimicrobial Agents and Chemotherapy. Boston, Oct 4, 1979 .
10 +
Veazey JM Jr, Duma RJ, Sonenshine D, et al:  Evidence for indigenous epidemic typhus in Virginia . Va Med 1979;;106:79.
11 +
McDade JE, Shepard CC, Redus MA, et al:  Evidence of Rickettsia prowazekii infections in the United States . Am J Trop Med Hyg 1980;; 29:277-284.
12 +
Reed LJ, Muench H:  A simple method of estimating 50% endpoints . Am J Hyg 1938;; 27:493-497.
13 +
Sonenshine DE, Bozeman FM, Williams MS, et al:  Epizootiology of epidemic typhus (Rickettsia prowazekii) in flying squirrels . Am J Trop Med Hyg 1978;;27:339-349.
14 +
Gerhard WW:  On the typhus fever . Am J Med Sci 1837;;19:289-292.
15 +
Hamilton HL:  Specificity of the toxic factors associated with the epidemic and the murine strains of typhus rickettsiae . Am J Trop Med 1945;;25:391-395.
16 +
Henderson RG, Topping NH:  Epidemic typhus fever: Neutralization of the toxic substance . NIH Bull 1945;;183:41-56.

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