Typhus Fever: Report of an Epidemic in New York City in 1847

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Abstract
An epidemic of typhus fever in New York City in 1847 that was associated with massive immigrations from Ireland is described by review of the records of 138 cases admitted to TheNew York Hospital during a seven-week period. Medical understanding of epidemic diseases, of typhus, and of therapeutics is examined. Most patients (80%) acquired the disease during passage, but 20% of the cases resulted from secondary spread in New York. The illness was characterized by high fever, headache, myalgias, and loss of appetite. Complications, most commonly central nervous system dysfunction and secondary bacterial infections, occurred in 29% of the cases. The mortality rate was II %. Therapy was directed at cleansing the bowel and diaphoresis. Bleeding was not employed. In spite of mistaken concepts about epidemic diseases, measures were employed that controlled spread of the disease.

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