Thursday, January 6, 2011

Of Lice and Men

The Lice
A poor man's clothes are ragged, quick to soil,
quick to soil and hard to get free of lice.
Between belt and skirt they nest,
climbing stealthily toward the collar.
So well hidden; how can I possibly find them?
They dine on my blood and nestle in my skin.
My life has give-and-take enough,
why poke my nose into yours?

Yao-Ch'en Mei, Chinese Government official [1002-1060]
Hamil, Sam; Crossing the Yellow River: Three Hundred Poems from the Chinese
Human body lice [Pediculosis corporis], historically referred to as Vagabond's disease, different from the schoolyard variety that many children get on their heads [Pediculosis capitis], is more common in areas of poor sanitation and hygiene.  Body lice and the diseases transmitted by them are the ones most depicted in art and literature.  They actually live in the seams of clothing, not directly on the body. There is also the less common pubic louse [Pediculosis pubis], or crabs, that usually occurs with other sexually transmitted diseases.

Lice are ectoparasites.  They don't just bite or sting [such as bees, ants, spiders, or caterpillars] but feast on the blood of their host.  The main ectoparasites are lice, fleas, ticks, certain flies, mosquitoes, and mites.  In history, they have been feared, fear fueled by lack of understanding and lack of treatment for the diseases that they can carry.  Some of the microorganisms that can be spread from them are bacteria, spirochetes, viral, rickettsial, helmintic and protozoa.

Certainly a different story from that of George and Lennie [Of Mice and Men], but typhus has struck people when they were down and out already.  The weakened bodies made them more vulnerable to disease as Lennie's mental weakness made him more vulnerable to misfortune. The Irish during 1845 to 1849 entered a hunger unlike any they had ever experienced.  The hunger was so great that starving children swelled with edema from malnutrition.  The hunger made them more susceptible to diseases like tuberculosis and diarrhea, and many infants died shortly after birth.  Poor sanitary conditions added to this hunger and made them more likely to carry human body lice, which at that time were commonly infected with relapsing fever [Borrelia recurrentis, a spirochete, which burrows through the skin after lice are crushed] and epidemic typhus [Rickettsia prowazekii].  Murine typhus [Rickettsia typhi] was perhaps carried by lice, but mainly by fleas.  It produces endemic typhus, but tends to be more mild than the epidemic form.  The epidemic typhus was the more likely culprit during the famine.  Rats and their fleas will be highlighted in the next posting.

Relapsing fever did just what it sounds like.  It would cause high fevers for several days, the person would then begin to feel better, then the fever would return.  Not too many cycles would go by before people died from it.  Relapsing fever killed many people in Ireland during the Great Hunger, but as there were no diagnostic tests, it's hard to separate out from typhus.  In WWI, over 50,000 deaths due to relapsing fever in soldiers occurred in Northern Africa and Europe.

Typhus by Théophile Hamel
1849 Montreal
Louse-born typhus, epidemic typhus, was called many things:  classic typhus, typhus examthematicus, tarbardillo, fleckfieber, and jail fever.  Within one week of infection, the typhus victum would have intense headache, chills, fever, myalgia [muscle ache], and a rash that would spread and darken.  Usually the face, palms, and soles of feet would be spared.  The person might also have cough, deafness and ringing in the ears. Eventually, many would die, especially the severely malnourished.  Between 1918 and 1922 over 30 million people in the Soviet Union and Eastern Europe were infected, and over 3 million died.  These infections and deaths were mainly in concentration camps.  There have been concentration camp survivors that still fight a recurrent form of typhus, Brill Zinsser disease.  By November of 1846 in County Cork, fever took hold and epidemic typhus began to sweep Ireland.  Both upper and lower classes died, in greater amounts than those who starved to death.  Shortly thereafter, the potato blight wiped out the crop and starvation worsened along with disease.  Those who could get away likely carried disease with them.  Many emigrants to Canada, mainly Montreal and Quebec, were also infected.

It is known that the Nazi's wouldn't knowingly set up camp or create concentration camps where there was typhus.  Some Polish doctors would inoculate patients with a substance to give false positives of typhus so that the Nazi's wouldn't enter their area.  For depiction of concentration camps and typhus, please visit this site to see Leslie Cole's images.  They are haunting.

Soldiers Hunting for Lice
Laszlo Mednyanszky 1915, from Wikipedia
Poor hygiene and sanitation also lead to Trench Fever [Bartonella quintana].  The symptoms are flu-like with aches and pains, fever, but also caused eye redness and nystagmus [rhythmic eye movements making focusing difficult], dizziness, rash, and enlargement of the spleen, and low blood protein.  Other names for trench fever are Rochilamaea quintana, Volhynia fever, Meuse fever, His-Werner disease, shinbone fever, shank fever, quintan or 5-day fever.  Some people infected with this variation of Bartonella were without symptoms; some had a single episode of illness, and some had periodic episodes.  The less fortunate ones had continual symptoms until they died.

World War I: Trench Warfare. (2011). The History Channel website. Retrieved 9:59, January 6, 2011, from http://www.history.com/photos/world-war-i-trench-warfare.














All these organisms still exist and cause problems in areas with poor sanitation and hygiene.  The fear is now less due to available treatment.  However, when treatment is not available or sought after, people can die from these infections.

Sources:

Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases: Expert Consult Premium Edition - Enhanced Online Features and Print (Two Volume Set)

The Great Hunger Ireland: 1845-1849 By Cecil Woodham-Smith (Penguin (Non-Classics), Paperback, 9780140145151, 528pp.)

4 comments:

  1. Now its very easy to contact with doctor .

    ReplyDelete
  2. @Health Online, in many areas yes...but unfortunately many people in the world are under-served. Thanks for reading.

    ReplyDelete
  3. Even on the outter areas of cities there's a lot of people with this problem.

    ReplyDelete
  4. @Joe Thomas, thank you for reading...yes, the problem still exists.

    ReplyDelete

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