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Typhus - Treatment and Prevention
Last reviewed: 04.07.2025
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All patients with suspected epidemic typhus should be hospitalized in an infectious diseases hospital (department). They are prescribed strict bed rest until the 5th-6th day of normalization of body temperature. Then the patients are allowed to sit up, and from the 8th day they can walk around the ward, first under the supervision of a nurse, and then independently. Patients must constantly monitor blood pressure.
No special diet is prescribed. Food should be gentle, quite high in calories and containing the daily vitamin requirement.
Oral hygiene (prevention of purulent mumps and stomatitis) and skin hygiene (prevention of bedsores) are of great importance.
Drug treatment of typhus
Treatment of epidemic typhus involves prescribing first-line drugs - antibiotics of the tetracycline group (tetracycline, doxycycline) and chloramphenicol. Antibiotics are prescribed in usual therapeutic doses: doxycycline orally at 0.1 g twice a day, from the second day - once a day; tetracycline orally at a daily dose of 2 g in four doses (for children 20-30 mg / kg). In case of intolerance to tetracyclines, epidemic typhus is treated with chloramphenicol at 0.5 g four times a day orally. Usually the course lasts 4-5 days.
To reduce intoxication, the patient is given plenty of fluids and intravenously administered 5% glucose solution, isotonic sodium chloride solution, polarizing mixture and similar drugs, forcing diuresis. To combat cardiovascular insufficiency, cardiac glycosides, vasopressors, and oxygen therapy are prescribed. In case of agitation and delirium, sedative therapy is administered [barbiturates, diazepam (seduxen), haloperidol, sodium oxybutyrate, remicidin].
In the development of infectious toxic shock, short courses of dextran (rheopolyglucin) in combination with glucocorticoids (prednisolone) are indicated. All patients are prescribed rutoside (ascorutin), which contains vitamins C and P, which have a vascular strengthening effect. To prevent thromboembolic complications, especially in elderly patients, anticoagulants are used [in the early period - sodium heparin (heparin), later - phenindione (phenylin), etc.] under the control of a coagulogram. Analgesics and antipyretics are indicated. In case of meningeal syndrome, dehydration is carried out with saluretics (furosemide, acetazolamide).
Rules of discharge
The patient can be discharged from the hospital no earlier than the 12th-14th day after the body temperature has returned to normal, provided there are no complications. The period of incapacity for work is determined individually, but no earlier than 2 weeks after discharge.
What is the prognosis for epidemic typhus?
In the past, the fatality rate was about 10%, reaching 30-80% during some epidemics. With the use of antibiotics, fatal outcomes are rare (less than 1%).
Clinical examination
The medical examination is carried out in the KIZ for 3 months, in the presence of residual effects - 6 months. Until the complete normalization of the central nervous system function, observation by a neurologist is necessary, in case of myocarditis - observation by a therapist.
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How to prevent epidemic typhus?
Prevention of epidemic typhus is aimed at combating pediculosis.
Persons with an increased risk of infection are vaccinated with vaccine E (combined live dry typhus vaccine) at a dose of 0.25 ml subcutaneously once; with revaccination after 1 year, or with dry chemical typhus vaccine at a dose of 0.5 ml subcutaneously once with revaccination after 4 months.
In the center of infection, sanitary treatment of patients, chamber disinfection of bedding, clothing and linen are carried out. Contact persons are observed for 25 days. Due to the difficulties of clinical diagnosis, the similarity of typhus with a number of other diseases accompanied by fever, the need for timely diagnosis of each case, all patients with fever for more than 5 days should undergo two (with an interval of 10-14 days) serological testing for epidemic typhus.