Volume 29, Issue 6
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


To the Editor:

We are pleased to have the opportunity to respond to the letter of Drs. Kaiser and Tustin. We agree that the differentiation of primary epidemic typhus (louse-borne, primary infection with ) from murine typhus fever (flea-borne, infection with ) is not usually possible on clinical grounds and that, specifically, for the patient of Drs. Kaiser and Tustin the clinical history which they kindly provided did not allow this differentiation. The clinical picture, including the distribution of rash, in these two diseases is very similar indeed; collectively, primary louse-borne typhus is more severe, especially in large epidemics. We concluded that in the group of cases reported in our article the severity was compatible with sporadic epidemic typhus. The patients we included were selected on the basis of the antibody response which, in the antibody absorption test, was typical of epidemic typhus fever.


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