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File: 123096_sep96_decls23_0040.txt
Subject: DIAGNOSIS AND TREATMENT OF DISEASES OF IMPORTANCE
Unit: OTSG
Parent Organization: HSC
Box ID: BX003203
Folder Title: DIAGNOSIS AND TREATMENT OF DISEASES 1991PORTABLE FIELD PERSONNEL SHOWER SYSTEMS
Document Number: 1
Folder Seq #: 88
EPIDEMIC TYPHUS (LOUSE-BORNE)
Communicability: hypotension
tachycardia
A. Route: jaundice (Uncommon)
I Body louse ( d@culus um@anis) infestation; inocu- oliguria
lation with louse feces through skin abrasions or meningismus
excoriations. cranial nerve palsies, including deafness/tinnitus
2. No evidence of person-to-person transmission. C. Laboratory:
B. Isolation: contact isolation required until after
delousing (by insecticide) of patients clothing, 1 Hematologic: leukopenia early; no eosinophilia;
bedding, quarters, and household contacts. Options: anemia and thrombocytopenia seen as disease
DDT; lindane; malathion; carbaryl. advances.
2. chemistry: azotemia, hypoalbuminemia, hypona-
C. Prophylaxis: tremia.
1. A killed organism vaccine is available but is 3. U/A: proteinuria.
recommended only for high risk individuals, not 4. Microbiology: culture may be possible in large
military personnel. Two doses, centers but not under field conditions or in small
10 to 14 days, apart may reduce incidence of hospitals.
disease, and diminishes mortality to almost nil. 5. Serology:
2. DOXYcycline, single dose, 200 mg. a. Weil Felix reaction (OX-19): 4 fold rise or
single titer > 1:320 in 2nd week of illness.
II. Incubation period: 12 days (range 5-23). b. Specific serologic testing: IFA r micro-
agglutination.
III. Diagnosis: 6. Coagulation: prolonged prothrombin time (PT).
A. Symptoms: abrupt onset. D. Invasive procedures: CSF my show pleocytosis.
sustained fever > 400C
severe headache E. X-ray: CXR may show pulmonary infiltrate.
prostration
back pain IV. Complications: sepsis, parotitis, pneumonia; rarely myocar-
limb pain ditis, CHF, thromboses,
non-productive cough
photophobia V. Treatment:
anorexia
A. Doxycycline, 200 mg PO, single dose.
nausea (uncommon)
vomiting (uncommon) B. Tetracycline, 250 mg PO QID, Until 3 days post defer-
diarrhea (uncommon) vescence (avoid if renal failure is present).
B. Signs: C. Chloramphenicol, 50 mg/kg/day, divided into 4 doses,
rash (90%); onset, day 3 to 5 of illness. Ini- until 3 days post defervescence.
tially in axillary folds, on abdomen and chest.
Centrifugal spread later. Initially roseolar, D. Relapse: repeating initial treatment is effective.
macular; becomes petechial. Rarely involves V. Disposition:
palms, soles or face. No eschar is seen.
profound lethargy/stupor
delirium A. Initial: hospitalization.
facial congestion
conjunctival injection B. Post treatment: prompt responders, return to duty;
splenomegaly complicated cases, with those with inadequate response
to treatment: evacuate.
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Document 52 f:/Week-36/BX003203/DIAGNOSIS AND TREATMENT OF DISEASES 1991PORTABLE FIELD PERSONNEL SHOWER SYSTEMS/diagnosis and treatment of diseases of importanc:12179609281524
Control Fields 17
File Room = sep96_declassified
File Cabinet = Week-36
Box ID = BX003203
Unit = OTSG
Parent Organization = HSC
Folder Title = DIAGNOSIS AND TREATMENT OF DISEASES 1991PORTABLE FIELD PERSONNEL SHOWER SYSTEMS
Folder Seq # = 88
Subject = DIAGNOSIS AND TREATMENT OF DISEASES OF IMPORTANC
Document Seq # = 1
Document Date =
Scan Date =
Queued for Declassification = 01-JAN-1980
Short Term Referral = 01-JAN-1980
Long Term Referral = 01-JAN-1980
Permanent Referral = 01-JAN-1980
Non-Health Related Document = 01-JAN-1980
Declassified = 17-DEC-1996