The only source of infection is diseased person with headlice which suck blood full of rickettsiae and diseased people transmit it to healthy person. Man gets infected while scratching bite spots by rubbing lice excrements into skin. Bite itself not leads to infection because pathogens of epidemic typhus are not found in salivary gland. In humans vulnerability to epidemic typhus is high.
Symptoms and course
Incubation period lasts 12 – 14 days. Sometimes in the end of incubation period patient experiences mild headache and body pains.
Body temperature increases and appears chill, the temperature is high (38 C) and in some cases it achieves maximum by the end of first day. Further, fever is permanent and temperature may decrease by 4, 8, 12th day of the disease. At the beginning appear acute headaches, insomnia, breakdown, excitement. Face is red and doughy. On eye conjunctiva sometimes appear small hemorrhages. Tongue is dry, not thickened and has dun fur on it. Skin is dry and hot by the feel. In the first days there is no sweating.
Occurs weakening of heart sounds, shortness of breath, increase of liver and spleen (on 3 – 4 day of disease). One of specific signs is typhus exanthema. Rash appears on 4 -5 day of disease. Rash is multiple, heavy, is located mainly in areas of belly-band surface, on arms flexure, and spreads on palms and feet. Rash never appears on face.
Rash gradually disappears (during 78 days) and leaves pigmentation for some time. With the rash patient's condition aggravates. Dramatically increases intoxication. Excitement is replaced with depression. At this time, collapse is developed: patient is exhausted, his skin is covered with cold sweat, pulse is frequent, heart sounds are dull. Recovery is characterized with body temperature lowering, headache decrease, sleep improvement, recovery of internals activity.
Treatment
Most effective are antibiotics of tetracycline group which should be taken 0,3 – 0,4g four times daily. Also may be used laevomycetin. When patient has normal body temperature, he should take antibiotics only two days, otherwise the course of treatment is 4 – 5 days. For detoxication is used 5% glucose solution. Oxygen therapy is recommended. Ultimate nutrition and vitamins are very important as well as right care for sick person (profound rest, fresh air, comfortable bed and clothing, everyday hygiene).
Prevention
- hospitalization of diseased people in time
- sanitary processing of disease focus
- monitoring of people who were in contact with diseased during 25 days
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