Abstract
The nonepidemic occurrence of typhus among residents of New York City was first reported by Brill in 1898.1A singular selection of persons who had been born in Eastern Europe was described. Later investigations conducted by Maxcy in the Southeastern United States of what was believed to be Brill's disease revealed that endemic typhus in this country was caused by a murine strain of Rickettsia transmitted by the rat flea and was not the louse-borne epidemic type.2In 1933 and 1934, Zinsser, through careful epidemiologic analysis of data assembled in New York and laboratory studies on cases observed in Boston, postulated that Brill's disease was probably a recrudescence of epidemic louse-borne typhus and not the endemic flea-borne type observed in Southeastern United States.3The strains isolated by Zinsser from 3 patients behaved like the European type and supported the belief that Brill's disease represented the classic European
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