Trench fever, caused by a Bartonella quintana infection found in lice and some spiders, mites, fleas, and ticks, affected nearly a million soldiers during World War I. Symptoms include high fever and leg pain, and it can last up to three months. Body lice are the most common transmitters, and it is still prevalent among the homeless and refugees. Treatment involves antibiotics and improving living conditions. It is fatal only among those with alcoholism or severe heart problems.
Trench fever is the result of a Bartonella quintana infection typically found in the feces of lice and the saliva of some spiders, mites, fleas, and ticks. Also known as five-day fever, urban trench fever, and quintana fever, it can last up to three months. Symptoms include extremely high fevers of up to 104° Fahrenheit (40° Celsius) and extreme pain in the legs. Although trench fever is rare outside the homeless population, it affected nearly a million soldiers during World War I.
Body lice, typically found where personal hygiene is lacking, are the most common transmitters of trench fever. Soldiers who served in World War I often fought in the trenches for long periods of time, forgoing bathing and leaving themselves prone to body lice and subsequent infection. During World War I and II, trench fever among soldiers was extremely high and typically caused men to be incapacitated for months. Today, those without access to running water or personal hygiene items, especially the homeless and refugees, are most commonly affected by trench fever.
Symptoms can manifest as a high fever, severe headaches, pain in the legs, and often a rash on the upper body. Although it may be confused with a normal fever, this disease is unique in that it causes the patient to relapse continuously over a period of five days. Symptoms typically come on quickly; the patient’s condition may improve progressively for five days, at which point the symptoms recur. This cycle can last up to three months, although the average recovery time is one month.
This disease is typically treated with a seven to 10-day course of antibiotics, most commonly doxycycline. Because reported cases are rare, there is little research into what the best course of treatment might actually be. Outside of medications, those who become infected are usually advised to improve their living conditions and cleanliness to avoid becoming infected again.
Despite the long recovery time, the infection is considered fatal only among those suffering from alcoholism or severe heart problems. The high fever caused by this disease can, in rare cases, lead to heart failure, which alcoholics and those who already have heart problems are already prone to. Cases of trench fever have been reported on every continent except Antarctica, where extreme cold makes transmission nearly impossible. However, cases of trench fever are rare, and if caught, the disease is highly treatable.
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