Epidemic typhus in the United States associated with flying squirrels
R. J. Duma, D. E. Sonenshine, F. M. Bozeman, J. M. Veazey Jr, B. L. Elisberg, D. P. Chadwick, N. I. Stocks, T. M. McGill, G. B. Miller Jr and J. N. MacCormack
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.
