In tropical regions of Africa, frequently subject to social and political upheavals, there is a present threat of typhus epidemics, as shown by the recent typhus outbreak in Burundi in 1997. Epidemic typhus should be expected in certain conditions such as: famine, war, high-density populations (refugee camps, prisons), the presence of body louse in the clothing, and in the presence of certain clinical findings. Symptoms include severe infectious syndrome (temperature above 38° C), severe pain and muscle weakness, with coughing and severe neurological signs. The rapid diagnosis and treatment of typhus are essential. The prognosis has improved, thanks to the specific antibiotics that are currently available, particularly doxycycline, prescribed as a single oral dose of 200 mg for adults or of 100 mg for children. However, the prognosis still depends to a large extent on the speed of diagnosis. Typhus epidemics could be effectively predicted and limited if the measures for contro!
             l of the body louse recommended by the World Health Organization were applied in the areas with the most favorable epidemiological conditions. Louse borne Typhus is the only rickettsial disease which can cause explosive epidemics in humans. In the past, it was associated with wars and human disasters and it is still endemic in the highlands and cold areas of Africa, Asia and Central and South America. Epidemic Typhus is characterized by the sudden appearance of headaches, chills, prostration, high fever, coughing and severe muscular pain. The case-fatality rate is between 1% and 20%. The body louse that causes this lives in clothing and multiplies very rapidly under poor hygienic conditions. Lice proliferate rapidly in refugee camps and other crowded, unsanitary conditions and the risk can be expected to increase in rainy seasons, when more clothing and blankets are used. Since World War II, large outbreaks of typhus have occurred mainly in Africa, wi
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