Diagnostic tests. R. prowazekii can be allocated from the blood by infection guinea pigs, mice, or at the yolk sack of chicken embryos, but because of the risk of laboratory infections are rarely done. Titles serum agglutinin to the Proteus OH-19 reached a peak in 2-3 weeks from the beginning of the disease, but indirect fluorescence antibody, or RCC is the preferred test. Diagnostic value in recognition of epidemic or endemic typhus has a fourfold increase in antibody titer of serum samples from acute phase and recovery phase. Test with absorption of antibodies often helps to differentiate the two diseases.
Treatment. Antibiotics choice – tetracycline (which should not give children under 9 years old) or Chloramphenicol. Early treatment usually gives a result in 2-3 days. Therapy should be to continue until the 2-3rd day after the normal temperature. For the destruction of lice can be applied pedikulotsidnye cream and gel containing Pyrethrin (0,16-0,33%) and piperonyl butoksid (2-4%), krotamiton (10%) or Lindane (1%). There is evidence that children who received locally excessive doses of lindane, are possible convulsions.
The isolation of hospitalized patients. Precautions are not recommended.
The control measures. We recommend a thorough destruction of lice in epidemic situations, especially among contacts. Because lice eggs are resistant to most drugs, often need to re-processing. Washing clothes in hot water kills lice and eggs. During the epidemic to kill lice are effective insecticides, raspylyaemye clothing infected with these parasites. In the United States there is currently no vaccine against the epidemic type.