Elsevier

The Lancet

Volume 357, Issue 9263, 14 April 2001, Pages 1198-1200
The Lancet

Eponym
Brill-Zinsser disease

https://doi.org/10.1016/S0140-6736(00)04339-7Get rights and content

Section snippets

Brill-Zinsser disease

Until the beginning of the 19th century, no clear clinical differentiation could be made between typhus and typhoid–two of the major pestilence fevers. By the end of that century, the development of typhoid agglutination tests (particularly the Widal test) and the availability of blood cultures to show typhoid bacillaemia made clinical differentiation possible. 95% of typhoid cases had agglutinins and more than 90% had Eberth bacillus in the blood.

Late in 1896, during an epidemic of typhoid

Latency of rickettsiae and the future of epidemic typhus in the west

In laboratory animals, rickettsiae can be recovered for substantial periods of time after acute infection. One agent, R tsutsugamushi (now Orientia tsutsugamushi), the agent of scrub typhus, can be isolated from rodents for months after acute infection. In addition, Smadel and colleagues4 showed that the organism could be found in the lymph nodes of human beings 1–2 years after infection. Similar observations have been reported for R rickettsii—the cause of Rocky Mountain spotted fever. Latent

Modern-day epidemic typhus

Although epidemic typhus might have caused more deaths than all of the wars in history, the overall importance of the disease had diminished substantially after the end of World War II. As a reflection of poverty, war, and famine, however, a re-emergence of typhus has been noted since 1995. Cases or small outbreaks have been reported from Russia,12 Peru,13 and Algeria,14 and a large outbreak has been reported in south-central Africa. The origin of this epidemic seems to have been related to a

Nathan Brill

Nathan Edwin Brill (figure 3) was born in New York City on Jan 3, 1860. He was educated in the New York public schools before attending the College of the City of New York. His medical training was at New York University Medical College, finishing in 1880. After graduation, Brill served as an intern at New York's Bellevue Hospital and subsequently practised general medicine. He was attracted to neurology, worked on the comparative anatomy of the nervous system, and produced a monograph on

Hans Zinsser

Hans Zinsser (figure 4) was born in New York City in 1878, the youngest of four sons of August and Marie Zinsser. As a young boy, his family made many trips to their German homeland whose culture was a major part of the Zinsser family life. In fact, German was Hans' primary language: he could not carry a conversation in English until he was 10 years old, having received his early education from home tutors. He became quite fluent in the English language under the guidance of Julius Sachs who

First page preview

First page preview
Click to open first page preview

References (16)

  • A Stein et al.

    Brill-Zinsser disease in France

    Lancet

    (1999)
  • I Tarasevich et al.

    Outbreak of epidemic typhus in Russia

    Lancet

    (1998)
  • D Raoult et al.

    Outbreak of epidemic typhus with trench fever in Burundi

    Lancet

    (1998)
  • NE Brill

    An acute infectious disease of unknown origin: a clinical study based on 221 cases

    Am J Med Sci

    (1910)
  • H Zinsser

    Varieties of typhus virus and the epidemiology of the American form of European typhus fever (Brill's disease)

    Am J Hyg

    (1934)
  • ES Murray et al.

    Brill's disease: II, etiology

    Am J Hyg

    (1951)
  • JE Smadel et al.

    Persistence of Rickettsia tsutsugamushi in tissue of patients recovered from scrub typhus

    Am J Hyg

    (1952)
  • WH Price

    Studies on the interepidemic survival of louse-borne epidemic typhus fever

    J Bacteriol

    (1954)
There are more references available in the full text version of this article.

Cited by (32)

  • The role of louse-transmitted diseases in historical plague pandemics

    2021, The Lancet Infectious Diseases
    Citation Excerpt :

    Among these pathogens, B quintana can remain for years in human organisms and populations.104 Similarly, typhus can relapse in the form of Brill-Zinsser disease up until 40 years after the initial infection with R prowazekii, indicating that humans can host the pathogen and transmit it through lice throughout their lifetimes.105,106 B recurrentis is also an endemic relapsing fever pathogen that persists in individual human beings.107

  • Post-bacterial infection chronic fatigue syndrome is not a latent infection

    2019, Medecine et Maladies Infectieuses
    Citation Excerpt :

    Latent typhus infection was identified in two animal models: mice and cotton rats. R. prowazekii was reactivated using dexamethasone, which induced an anti-inflammatory effect on the host's innate immune response [81,82]. However, the mechanism of R. prowazekii dormancy and reactivation in humans has not been established.

  • Other Rickettsia Species

    2018, Principles and Practice of Pediatric Infectious Diseases
  • Rickettsial Infections

    2016, Tropical Dermatology: Second Edition
  • Other Rickettsia Species

    2012, Principles and Practice of Pediatric Infectious Diseases, Fourth Edition
View all citing articles on Scopus
View full text