Abstract
Typhus fever (TF) is caused by the bacillus Rickettsia prowazekii and is generally passed to humans by infected fecal matter of the body louse. War, natural disasters, or other situations leading to crowding and poor sanitation can cause an increase in TF cases. Providers must employ contact and airborne precautions when dealing with cases of TF. Symptoms are nonspecific, and the diagnosis is easily missed. Early initiation of doxycycline is the treatment of choice. Brill-Zinsser disease, a mild form of TF, can recur in treated patients and seed a new epidemic. TF is a potential bioterrorism agent because of moderate ease of distribution, relative stability, and moderate casualty rates. Isolation and decontamination are key to managing outbreaks.
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