November 1, 2012

Medicine in the Nineteenth Century: Bloodsuckers (and I don't mean vampires) Part 2

Delousing plant. 1918 U.S. Army Hospital, France, WW I
Are lice ever nice? No.  But some lice are nicer than others.  For instance, head lice, the scourge of school children, though disgusting ,doesn't seem to transmit any diseases.  Body lice, on the other hand, causes the disease typhus (not to be confused with typhoid fever - an entirely different disease). Lice suck human blood and often poop at the same time (I know, ick!).  When the person who has the lice scratches the place where he was just bitten, the poop (or feces for you medical types) is carried into the wound.  The bacteria that causes typhus, Rickettsia prowazekii, is in the poop. 

Body lice occur wherever people live in overcrowded, unsanitary conditions with no or few opportunities to wash themselves or their clothing.  Epidemics have occurred throughout history, especially in times of war, extreme poverty and cold weather where people huddle together indoors.

The nineteenth century saw devastating epidemics of typhus.  More soldiers died of typhus during Napolean's wars than did of injuries sustained in battle (300,000 from typhus versus 100,000 from battle wounds).  Typhus decimated the Irish population in waves in 1816, 1821, 1836 and 1846.  The year 1846 was particularly bad.  The Irish were starving as a result of the potato famine.  Forced into workhouses, an estimated 190,000 people died of the disease.  The twentiety century saw typhus in the Civil War and both World Wars.

It wasn't until 1910 that the transmission of typhus by body lice was proven.  A vaccine was developed during World War II.  Today, typhus still occurs, not so much in America, but in Eastern Europe, the Middle East and Africa.

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