An Outbreak of Endemic Typhus Fever in Nashville, Tennessee—Its Epidemiology and Control

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Abstract
An outbreak of endemic typhus fever occurred in Nashville in 1939, involving 75 cases, with a case fatality rate of 2.7%. While the first case of this disease in Tenn. occurred in 1926, the first known cases in Nashville were reported in 1935. It appeared that a focus of infection was established first in this city in a feed mill, located on 2 railroads in the southern part, a short distance from where they enter the city. By Jan. 1, 1939, 31 cases had been reported. In the outbreak reported, one or the other of 3 foci in Nashville was detd. to be the probable source of infection for 70 cases. An eradication of rats was instituted in the areas surrounding each focus through trapping, poisoning, removal of garbage and trash, starting several blocks in radius from each focus and working inward. Foci of the disease have been established in 3 other cities in Tennessee, and since the disease is spreading inland from the original foci in the southeastern States, State and local health officials in general and those of the southern States in particular must consider seriously active programs of rat control.

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