History and Geography

Although murine typhus was identified only during the twentieth century, it may be an even older disease than classic, epidemic typhus. Neither of the two hosts of R. typhi, the rat and the rat flea, suffer ill effects from their infection with the organism, whereas R. prowazekii inevitably kills its vector louse and causes a serious illness in its human host.

Sporadic cases of typhuslike fevers in areas free from lice were reported early in the twentieth century in the United States, Malaya, and Australia. Often these infections were designated by local names, such as "urban" or "shop" typhus. It was not until 1926, however, that the distinctiveness of this disease was recognized. During an epidemiological investigation of such cases in the southeastern United States, U.S. Public Health Service investigator Kenneth F. Maxcy described an endemic form of typhus fever and postulated that some ectoparasite of the rat might be its vector. By 1931, infected fleas had been found in nature, confirming Maxcy's hypothesis. Although the name "endemic typhus" was used for some time, it was shortly observed that the disease could occur in epidemics as well as sporadically. In 1932 Mooser proposed that the disease be called "murine typhus" instead to indicate its relationship to rats.

Although broad-spectrum antibiotics provide effective treatment against this disease, its mild course and low fatality rate make these measures almost unnecessary. By the time the disease is diagnosed, the patient is usually in convalescence.

Victoria A. Harden

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