Subject(s)
Communicable Diseases/history , Communicable Diseases/mortality , World War I , Gas Gangrene/history , Gas Gangrene/mortality , History, 19th Century , History, 20th Century , History, 21st Century , Humans , Influenza, Human/history , Influenza, Human/mortality , Trench Fever/history , Trench Fever/mortality , Typhoid Fever/history , Typhoid Fever/mortality , Typhus, Epidemic Louse-Borne/history , Typhus, Epidemic Louse-Borne/mortalityABSTRACT
In August 2012, laboratory tests confirmed a mixed outbreak of epidemic typhus fever and trench fever in a male youth rehabilitation center in western Rwanda. Seventy-six suspected cases and 118 controls were enrolled into an unmatched case-control study to identify risk factors for symptomatic illness during the outbreak. A suspected case was fever or history of fever, from April 2012, in a resident of the rehabilitation center. In total, 199 suspected cases from a population of 1,910 male youth (attack rate = 10.4%) with seven deaths (case fatality rate = 3.5%) were reported. After multivariate analysis, history of seeing lice in clothing (adjusted odds ratio [aOR] = 2.6, 95% confidence interval [CI] = 1.1-5.8), delayed (≥ 2 days) washing of clothing (aOR = 4.0, 95% CI = 1.6-9.6), and delayed (≥ 1 month) washing of beddings (aOR = 4.6, 95% CI = 2.0-11) were associated with illness, whereas having stayed in the rehabilitation camp for ≥ 6 months was protective (aOR = 0.20, 95% CI = 0.10-0.40). Stronger surveillance and improvements in hygiene could prevent future outbreaks.
