In 1938, when Nazi Germany annexed Austria, Nussimbaum fled to Italy and settled in the seacoast town of Positano. He died there of a rare blood disorder which causes gangrene of the extremities. This was most likely Buerger's disease, which is known to afflict Ashkenazi male Jews, rather than Raynaud's Disease, which is more prevalent in women. It is highly likely that Essad Bey denied his Jewish ancestry to doctors who were treating him, which led to the misdiagnosis of Raynaud's instead of Buerger's. Little was known in the early 1940s about Buerger's disease, especially that the disease could be reversed if the patient stopped smoking. Essad Bey, who was known to be a heavy smoker, died a painful death at the age of 36.