Epidemic Typhus (there are 3 types of typhus; epidemic typhus is one)

choi

Epidemic Typhus
Lisa Sanders, Online Sleuthing; How a joke About flying squirrels led to an ailing woman's cure. New York Times Magazine, June 25, 2017.
https://www.nytimes.com/2017/06/ ... ng-womans-cure.html

Note:
(a) A man was told "that their mother was deathly ill. Seeing her now, a pale, silent version of her energetic self, he feared he would have to wear the suit he'd brought after all."
(i) deathly (adj): "of, relating to, or suggestive of death  <a deathly pallor>"
https://www.merriam-webster.com/dictionary/deathly
(ii) There are a few occasions that a man has to wear a suit, one of which is attending a funeral.

(b) "The wintry late-day sun [which is the clause 1 of the essay] * * * a tiny 93-year-old woman * * * [Told by his sibling that this might be the end, an older son flew in from Missouri] The frail woman didn’t open her eyes when her older son entered the room. He leaned close to give her a kiss and straighten her up in the bed. Did she have flying-squirrel fever, he asked lightly, referring to their effort the autumn before to rid her attic of the pesky rodents. Back then she told him how cute the big-eared babies were, creatures taken out of the attic by the exterminator on their way to relocation. He thought she smiled a bit at his joke, just a whisper of her usual good humor. But as he made the joke, he suddenly had a thought: Could those squirrels have anything to do with this strange illness that no one could figure out?  It was an odd thought but the kind of connection that inspired the son, so he found a computer in the hospital and searched online a bit. The first pages carried mostly ads for services to get rid of the pests. But then he found something: a short article from the Centers for Disease Control and Prevention linking flying squirrels with something called epidemic typhus. Further reading revealed that the symptoms of typhus — fever, body aches, rash and confusion — resembled those his mother had. But typhus was a rare infection. There had been fewer than 100 cases in the United States reported to the CDC over the past 40 years."

The essay did not give a precise timeline. But this is enough. See (e) below).

(c) "Epidemic typhus is an old disease. Since the Middle Ages, periodic epidemics of this infection killed millions of people. Just after World War I, an outbreak in Russia killed three million. The infection is often transmitted through contact with a body louse. Modern sanitation has significantly reduced the incidence of both infection and carrier. In the United States, most cases of typhus have come from exposure to flying squirrels. It’s not clear how the bacteria get from the rodents who harbor the bug to the humans they infect"

For historical epidemic, see typhus
https://en.wikipedia.org/wiki/Typhus
(section 6 History)

Certain people in US are still infested with lice (eg, homeless shelters). Surprisingly, lice survive laundry cycles, to infect another who use, say, the same bed sheets. Otherwise in modern world, human lice -- there are three kinds: head, body and public -- do not move from one person to anoterh.

(d)
(i) Typhoid fever 伤寒 is caused by bacteria Salmonella typhi "growing in the intestines and blood. Typhoid is spread by eating or drinking food or water contaminated with the feces of an infected person."
https://en.wikipedia.org/wiki/Typhoid_fever
(ii) Typhus 斑疹傷寒 (but typhoid fever has rash, too) is caused by "Rickettsia prowazekii spread by body lice."
https://en.wikipedia.org/wiki/Typhus
(A) Rickettsia prowazekii
https://en.wikipedia.org/wiki/Rickettsia_prowazekii
(section 1.1 Discovery: A Brazilian MD in 1916 named after Czech zoologist Stanislaus von Prowazek)
(B) The genus name Rickettsia was named after an American, Howard Taylor Ricketts (1871 – 1910), who received MD from Northwestern University. He identified the pathogen of Rocky Mountain spotted fever (RMSF) -- "the most lethal and most frequently reported rickettsial illness in the United States" en.wikipedia.org -- as Rickettsia rickettsii spread to humans by a kind of ticks. He died at 39 of epidemic typhus at Mexico City when studying it, struck by similarities of the two diseases and suspected they were caused by similar pathogens (they are).

(e)
(i) Epidemic Typhus. CDC, undated
https://www.cdc.gov/typhus/epidemic/index.html
("In the United States, rare cases of epidemic typhus, called sylvatic typhus, can occur. These cases occur when people are exposed to flying squirrels and their nests")

This Web page also carries a photo of an adult flying squirrel.
(ii) Reynolds MG et al, Flying Squirrel–associated Typhus, United States. Emerging Infectious Diseases, 9: 1341-1343 (2003).
https://wwwnc.cdc.gov/eid/article/9/10/03-0278_article

Quote:

"Flying squirrels are the only known vertebrate reservoir, other than humans, of R prowazekii, and contact with these animals has been linked to most sporadic typhus cases in the United States.

Regarding patient 1: "Because the patient was a recreational hunter, serologic tests for Rocky Mountain spotted fever, ehrlichiosis, adenovirus, Lyme disease, and cytomegalovirus (CMV) [and some days later, when initial treatment did not improve, serologic testing for typhus group rickettsiae] were ordered * * * During January [ie, a month before he developed symptoms in February 2002], the patient had spent several nights in a hunting cabin in a rural area of Hardy County, West Virginia. Flying squirrels had infested the cabin every winter for several years

Regarding patient 2: "Additional history was obtained from the patient’s wife, who reported that 2 weeks before onset of symptoms, the patient had removed a flying squirrel carcass from the air intake chamber of the furnace in his office building's basement."

* You see, symptoms are similar among many diseases. Indeed, symptoms of typhus is not unique to make a diagnosis. So a battery of blood tests were done, to pinpoint the pathogen.