We report epidemic typhus in a French patient returning from Algeria. The diagnosis was confirmed by serologic testing and the isolation of Rickettsia prowazekii in blood. Initially the patient was thought to have typhoid fever. Because body lice are prevalent in industrialized regions, the introduction of typhus to pediculosis-endemic areas poses a serious public health risk. Epidemic typhus, caused by Rickettsia prowazekii , is transmitted in the feces of the infected body louse.
Body lice live in clothing and are easily controlled by good personal hygiene.
Louse-infested populations are primarily those who live in extreme poverty. Figure 1 Click to view enlarged image Figure 1. He was a native Algerian, who lived in France but had visited Msila, a small town in east central Algeria, for 3 months. The patient recalled pruritis and scratching during his stay in Algeria. However, no lice were found on his clothing.