Brill's disease. IV. Study of 26 cases in Yugoslavia.

Abstract

IN 1934 Zinsser defined Brill's disease as sporadic typhus occurring in the absence of lice among immigrants to the United States from the typhus-ridden areas of southeastern Europe.1 Subsequently, physicians in Switzerland,2 France,3' 4 England,5 and Portugal6 reported occasional cases of Brill's disease among immigrants and displaced persons from the typhus regions of Europe. There are no reports, however, that Brill's disease has been recognized as such in any area where typhus fever actually occurs in epidemics among the local population. If Brill's disease is indeed a recrudescence of typhus in individuals who previously have had the disease, as postulated by Zinsser,1 then it should be occurring at the present time in those parts of the world where typhus epidemics have been widespread in the past 25 to 50 years. To investigate this possibility, we undertook a search for Brill's disease in Bosnia, Yugoslavia, where we know from