John Donne, Spanish Doctors and the epidemic typhus: fleas or lice? / John Donne, médicos españoles y el tifus epidémico: ¿pulgas o piojos?

We describe the infections that appeared in the life and work of John Donne (1572-1631), the English metaphysical poet, mainly the exanthematic typhus that suffered and gave arise to his work Devotions upon emergent occasions, and several steps in my sickness. We discuss the vector of transmission of this disease, in comparison of other infections in that period, that Donne's scholars have related to the flea without mentioning the body louse, the true vector of the exanthematic typhus. Likewise, we mention the exanthematic typhus's symptoms in his Devotions in comparison with the Luis de Toro's or Alfonso López de Corella's works, Spanish doctors in those times and the first doctors in write books about the disease, and the singular treatment of pigeon carcasses on the soles of the feet in English Doctors but not in Spanish Doctors

Se describen las infecciones que aparecieron en la vida y la obra de John Donne (1572-1631), el poeta metafísico inglés, principalmente el tifus epidémico que padeció y que dio lugar a su obra "Devotions upon emergent ocassions, and several steps in my sickness". Discutimos el vector transmisor de la enfermedad, en comparación de otras infecciones en ese periodo, que los estudiosos de Donne han relacionado a las pulgas y sin mencionar el piojo del cuerpo que es el verdadero vector del tifus epidémico. Además, mencionamos los síntomas de la enfermedad en su obra "Devotions" en comparación con los trabajos de Luis de Toro o Alfonso López Corella, médicos españoles de su tiempo y los primeros en escribir los tratados sobre la enfermedad, y el tratamiento singular de las carcasas de palomas en las palmas y plantas de los pies en los médicos ingleses pero no presente en los médicos españoles

John Donne, Spanish Doctors and the epidemic typhus: fleas or lice?

We describe the infections that appeared in the life and work of John Donne (1572-1631), the English metaphysical poet, mainly the exanthematic typhus that suffered and gave arise to his work Devotions upon emergent occasions, and several steps in my sickness. We discuss the vector of transmission of this disease, in comparison of other infections in that period, that Donne´s scholars have related to the flea without mentioning the body louse, the true vector of the exanthematic typhus. Likewise, we mention the exanthematic typhus´s symptoms in his Devotions in comparison with the Luis de Toro´s or Alfonso López de Corella´s works, Spanish doctors in those times and the first doctors in write books about the disease, and the singular treatment of pigeon carcasses on the soles of the feet in English Doctors but not in Spanish Doctors.

Typhus Group Rickettsiosis, Germany, 2010-20171.

Typhus group rickettsiosis is caused by the vectorborne bacteria Rickettsia typhi and R. prowazekii. R. typhi, which causes murine typhus, the less severe endemic form of typhus, is transmitted by fleas; R. prowazekii, which causes the severe epidemic form of typhus, is transmitted by body lice. To examine the immunology of human infection with typhus group rickettsiae, we retrospectively reviewed clinical signs and symptoms, laboratory changes, and travel destinations of 28 patients who had typhus group rickettsiosis diagnosed by the German Reference Center for Tropical Pathogens, Hamburg, Germany, during 2010-2017. Immunofluorescence assays of follow-up serum samples indicated simultaneous seroconversion of IgM, IgA, and IgG or concurrence in the first serum sample. Cytokine levels peaked during the second week of infection, coinciding with organ dysfunction and seroconversion. For 3 patients, R. typhi was detected by species-specific nested quantitative PCR. For all 28 patients, R. typhi was the most likely causative pathogen.

CONTRIBUTIONS TO RICKETTSIOSES RESEARCH IN COLOMBIA (1917-1943), LUIS B. PATIÑO CAMARGO.

Colombian physician Luis Benigno Patiño Camargo was one of the pioneers in the study of rickettsioses in South America, demonstrating for the first time in Colombia the presence of Rickettsia rickettsii as the etiological agent of a highly deadly exanthematic febrile syndrome in the 1930s. However, Patiño-Camargo performed other investigations from 1917-1943, which represent the first descriptions and scientific evidence of the presence of R. prowazekii and R. typhi in Colombia. Almost 60 years after the latest research conducted by Dr. Patiño-Camargo, rickettsioses were again a matter of interest and research. In the last decade over 20 research studies have been published, showing new endemic areas for R. rickettsii, as well as the description of new rickettsial species in Colombia.

Murine typhus, Reunion, France, 2011-2013.

Murine typhus case was initially identified in Reunion, France, in 2012 in a tourist. Our investigation confirmed 8 autochthonous cases that occurred during January 2011-January 2013 in Reunion. Murine typhus should be considered in local patients and in travelers returning from Reunion who have fevers of unknown origin.

[Spotted typhoid fever in the Iceland of the sagas?]. / Flekktyfus på sagatidens Island?

In spite of Iceland's geographically isolated position, epidemics of infectious diseases obviously occurred from the very beginning, brought to the island by the first Norwegian settlers and their cattle in the 9th century. People living close together in small farming communities were of course exposed to infection, which must have been common in the narrow Icelandic farmhouses. People had very little understanding or knowledge of protection against contagion, and the whole family, often sleeping together in the same bed, would be an easy prey to contagion. Epidemics were often regarded as caused by supernatural, evil forces, and two of the Icelandic sagas in particular - Grette's Saga and the Eyrbyggja Saga - give an account that may well be the first ever description of an epidemic, perhaps of spotted typhoid fever, in the history of medicine. In these sagas, the accounts are presented as ghost stories. The disease is caused by the faeces of infected lice, and leads to severe haemorrages in the skin and intestine. It also affects the central nervous system and has a high mortality rate.

[Modern principles of prevention of human transmitted infections].

According to information about ecology of agents of parasitic diseases with lousy-flea mechanism of contamination, mite natural diseases and experience of battle with them, we can make a conclusion: elimination of spongers in their natural environment, lousies and fleas by washing and disinfection is not effective. Alternative is implementation of insectoacaricides of new class, based on permethrins. These insectoacaricides are secure for environment and very effective towards arthopods. Method of non-termal preventing suction of arthopods is probed in military practice and other treatment-prophylaxis institutes. It is proposed to implement new insectoacaricides in form of spray cans as part of individual contrebiological drug-locker of every service man, acting in difficult epidemiological situation, caused by virus threat of lousy or flea infection, or by beforehanded provision by impregnated uniform or clothes.

[Rudolf Stefan Weigl--scientist and human being]. / Rudolf Stefan Weigl--czlowiek i uczony.

Rudolf Stefan Weigl died in 1957, 45 years ago. This year we are celebrating 120 anniversary of his birthday. He was a great Polish scientist who led research on Rickettsia prowazeki and epidemic typhus. R. Weigl developed a method of R. prowazeki culture in louse gut and elaborated the technology of epidemic typhus vaccine production. He and his co-workers introduced first vaccination of medical staff, people from endemic area in Poland and missionaries working in Asia. He was an international authority on prophylactics and control of rickettsial epidemic typhus.

Epidemiologic classics of Carter, Maxcy, Trudeau, and Smith.

Four great epidemiologists whose work so concisely linked clinical observations, epidemiologic clues, and logical preventive measures are discussed. Henry Rose Carter set the stage for the Walter Reed successes in Cuba by showing that 9-16 days must elapse after contact before yellow fever develops. This provided the link for the Reed group to allow the "virus" to incubate in the mosquito before becoming infectious. Kenneth Maxcy clarified the controversy between endemic typhus fever and Brill's disease in the southeastern United States. His clinical, epidemiologic, and laboratory findings led him to propose that the causative organism (Rickettsia typhi) was in rodents and the probable vector, fleas. When confirmed, effective control measures were applied. Two other American investigators, Edward L. Trudeau and Theobald Smith, helped prove Robert Koch wrong on three counts: (1) Tuberculin is not an effective therapeutic agent for tuberculosis; (2) there are two distinct types of tubercle bacillus, human and bovine; and (3) the bovine form of Mycobacterium tuberculosis is remarkably pathogenic for humans. The significance of these findings is unlimited.

The pied Piper of Hamelin. A medical-historical interpretation.

A historical basis is proposed for the 13th-century legend of the Pied Piper, who led away the rats from the town of Hamelin and when refused payment for his services, led away 130 children and disappeared with them in the mountains. It is suggested that the children actually died in an outbreak of disease and were buried in a common grave at the site of the legendary disappearance. The association with rats points to a rodent-borne infection, and the pied (mottled) coat of the piper seems to indicate a disease causing conspicuous macular lesions. Historical and epidemiologic arguments are presented in favor of murine typhus as the predominant infection in the Hamelin epidemic.