Miep Gies, who helped Anne Frank hide, dead at 100.

Miep Gies, the secretary who helped hide Anne Frank and her family for two years has died at age 100. Gies is also responsible for having saved the teenager’s diary, which was later published by Anne’s father, the only family survivor. “The Diary of Anne Frank” was the first popular book about the Holocaust, and has been read by millions of children and adults around the world in some 65 languages. Most know that Anne Frank died at the age of 15 in the Bergen-Belsen concentration camp in March 1945, just two weeks before the camp was liberated. What many do not know is that Anne Frank died of typhus.

Typhus is a bacterial infection, spread by lice or fleas. There are two forms of typhus, depending on which one of two bacteria (Rickettsia typhi or Rickettsia prowazekii) is causing the disease.

Rickettsia typhi causes murine or endemic typhus which is uncommon in the United States. It is usually seen in areas where hygiene is poor and the temperature is cold. Lice and fleas of flying squirrels spread the bacteria. Murine typhus occurs in the southeastern and southern United States, often during the summer and fall. It is rarely deadly. Risk factors for murine typhus include: Exposure to rat fleas or rat feces or exposure to other animals (such as cats, opossums, raccoons, skunks, and rats).

Rickettsia prowazekii causes epidemic typhus and Brill-Zinsser disease. Brill-Zinsser disease is a mild form of epidemic typhus. It occurs when the disease re-activates in a person who was previously infected and is more common in the elderly.

Symptoms of murine typhus may include:

• Abdominal pain
• Backache
• Dull red rash that begins on the middle of the body and spreads
• Extremely high fever (105 - 106 degrees Fahrenheit), which may last up to 2 weeks
• Hacking, dry cough
• Headache
• Joint pain
• Nausea and Vomiting

Symptoms of endemic typhus may include:

• Chills
• Cough
• Delirium
• High fever (104 degrees Fahrenheit)
• Joint pain
• Lights that appear very bright; light may hurt the eyes
• Low blood pressure
• Rash that begins on the chest and spreads to the rest of the body (except the palms of the hands and soles of the feet)
• Severe headache
• Severe muscle pain

The early rash is a light rose color and fades when you press on it. Later, the rash becomes dull and red and does not fade. People with severe typhus may also develop small areas of bleeding into the skin (petechiae).

Treatment consists of antibiotics, typically tetracycline or doxycline, and supportive therapy such as fluids, medications for fever, and so on.

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