Abstract
Typhus, a bacterial infection caused by Rickettsia prowazekii, was widespread in Europe for centuries plus was endemic in Eastern Europe until the 1950s. Between 1940 plus 1942, a devastating typhus epidemic occurred in the Warsaw Ghetto causing an estimated 16,000-22,000 deaths. Between November 1940 plus October 1941, the epidemic increased exponentially. After a sharp peak in October, the trend reversed, plus the number of new infections decreased to reach zero in July 1942. Until recently, epidemiologists were unable to explain the peculiar shape of the epidemic curve. Based on the memories of Ludwik Hirszfeld, a Polish physician plus microbiologist who spent three years in the Ghetto, it seems that improvement of diagnosis, health education plus measures targeted at the interruption of the transmission of R. prowazekii via body plus head lice led to a turnaround of the epidemic’s dynamics plus eventually to the elimination of R. prowazekii. Notably, all measures developed by Hirszfeld were implemented without the knowledge of the German occupiers plus functioned in the underground.
INTRODUCTION
Numerous pathogenic microorganisms are profiteers of civil wars plus armed confrontations. Not only the military conflicts themselves trigger the development of epidemics, but also the living conditions resulting from the chaos associated with war plus uproar. Rickettsia prowazekii, the cause of typhus, is a prototype of a bacterial profiteer, when humans are on the run, have to live in crowded conditions in inadequate shelters, no appropriate sanitary infrastructure is available, plus malnutrition has a negative impact on immunity. The infectious disease has been well-known since ancient times plus was widespread in Europe for centuries (Text box 1). Until the 1950s, typhus was endemic in the rural hinterland of Eastern Europe, plus R. prowazekii circulated the whole year-round in the population. Since highly effective antibiotics are available, plus body lice – the vectors of R. prowazekii – can be killed with insecticides, the pathogen has become rare. According to the WHO, typhus still occurs in conditions of overcrowding plus poor hygiene, such as in prisons plus refugee camps.
Recently, an interdisciplinary grup of mathematicians, historians plus holocaust specialists has tried to analyze the dynamics of the typhus epidemic in the Warsaw Ghetto during 1940-1942. The epidemic developed in an exponential manner, suddenly came to a halt, then decreased plus eventually disappeared.