Napoleon, Typhus, and Trench Fever
Abstract & Commentary
By Stan Deresinski, MD, FACP, Clinical Professor of Medicine, Stanford; Associate Chief of Infectious Diseases, Santa Clara Valley Medical Center, is Editor for Infectious Disease Alert.
Synopsis: Retreating troops of Napoleon’s army were devastated by two louse-borne diseases, typhus and trench fever.
Source: Raoult D, et al. Evidence for Louse-Transmitted Diseases in Soldiers of Napoleon’s Grand Army in Vilnius. J Infect Dis. 2006;193:112-120.
Raoult and colleagues examined material from a recently uncovered mass grave site dating to 1812 in Vilnius, Lithuania, and identified the presence of body lice (Pediculus humanus), 3 of 5 of which contained DNA of Bartonella quintana, the etiologic agent of trench fever. DNA of B. quintana was also identified by PCR and sequencing in the dental pulp of 7 of 35 soldiers, while DNA of Rickettsia prowazekii, the agent of epidemic louse-borne typhus, was identified in 3 of the 35.
In the autumn of 2001, construction workers in the Siaures Miestalis ("Northern Town") section of Vilnius uncovered a mass grave containing several thousand neatly stacked skeletons, most in a fetal position. While initial assumptions led to conjectures that these were victims of either the Nazis or of the Soviet Red Army, examination of medals, buttons, coins, and cloth found with the remains indicated that they were soldiers of the Grand Armée, members of 40 different regiments, who had died during Vilnius in that ghastly frigid winter of 1812, toward the end of the Little Ice Age.
The humiliating return of the Grand Armée to Vilnius in December 1812 was a pitiful contrast to the scene earlier that year when more than half a million soldiers from multiple nations had gathered there to set off to invade and conquer Russia. The fact that fewer than 10% of that vast army escaped the Russian countryside to reach the capital of the Duchy of Lithuania was evidence that they were the conquered, rather than the conquerors. Unfortunately for them, the horror was not yet over—only approximately 3000 would ultimately reach home.
Napoleon himself did not tarry in Vilnius on his way back from Moscow, but returned directly to Paris. He was not alone in fleeing—Napoleon’s brother-in-law, later the King of Naples who had been left in command, left Vilnius declaring, "I’m not going to be trapped in this piss-pot." He made a good choice. Vilnius became a charnel house for the rest—not as the result of combat, but as the result of cold, famine, and, importantly, typhus. Thus, it has been said that several "Generals" defeated Napoleon’s army. These include "General Cold" and "General Famine", but perhaps most important of all was "General Typhus".
Rickettsia prowazekii causes epidemic louse-borne typhus, recrudescent typhus (Brill-Zinsser disease), and flying squirrel-associated typhus. It has previously been suggested, based on descriptive information, that louse-borne typhus may have killed as many as half of Napoleon’s Grand Armée. The findings by Raoult and colleagues, that definitively identify R. prowazekii-associated mortality among members of the army who died in Vilnius during their retreat, is the first scientifically acceptable evidence in support of typhus as a cause of mortality among Napoleon’s troops.
Bartonella quintana, which is also transmitted by body lice, is the cause of trench fever, an infection which was reported in 1915 among lice-infested soldiers in the trenches of the Western Front of World War I. It currently is predominantly identified in homeless individuals.
In past centuries, infectious disease was the leading cause of mortality among soldiers at war. Napoleon’s Grand Armée, assembled for the invasion of Russia, was no exception. While cold, famine, and Russian troops took their toll, the human body louse and 2 of its associated human pathogens may have provided the death knell.
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