A disease of definite characteristics which has appeared in the southeastern United States, according to observations reported by Maxcy, 1 seems to be endemic typhus. Serologically and clinically, except that it runs a mild course, this disease is indistinguishable from Old World typhus, and is, apparently, identical with Brill's disease. On the other hand, epidemiologically it differs from Old World typhus. That the body louse is the vector of the Old World form of the disease is well known. Transmission of the virus by the body louse in the conditions seen in the southeastern United States has been found to be distinctly unlikely. The Old World disease occurs with greatest frequency in winter, whereas, in the region under investigation, it reaches its peak in the summer and autumn. Although, in Europe, typhus is occasionally transmitted to a cleanly person by the random bite of an infected louse, this is not
PROBABLE TYPHUS IN SOUTHEASTERN UNITED STATES. JAMA. 1927;88(5):325–326. doi:10.1001/jama.1927.02680310037013
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