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Brill's illness

Table of contents
Brill's illness
Etiology and epidemiology
Classification, pathogeny, clinic
Diagnosis, complications and outcomes

Brill's illness — cyclically proceeding infectious disease representing endogenous recurrence of an epidemic sapropyra at the people who transferred many years ago primary form of this disease. The illness is characterized by a sporadichnost in the absence of carriers and easier, than an epidemic sapropyra, a current.
The illness received the name in honor of scientific N. E. Brill which for the first time described a clinical picture of a "unknown" illness and which paid attention to its similarity to clinic of an epidemic sapropyra.
Synonyms: a repeated sapropyra, a recurrent sapropyra, a sporadic sapropyra, Brill's illness — Tsinssera.
Lat. — Brilli morbus.
English — Brill's disease, Brill — Zinsser's disease.

Short historical data.

For the first time in 1910 N. E. Brill in New York paid attention to the acute infectious disease with symptomatology, characteristic of a sapropyra, but which arose in the absence of a pediculosis among the diseased and people surrounding the patient. The scientist gave it the name "infectious disease of an unknown origin" that was a reason for further studying of its etiopathogenesis. And only in 1934 N. Zinsser suggested that this illness is recurrence of the sapropyra postponed in the past, result as if of "awakening" is long the latent rickettsial infection existing in an organism.
In many years N.'s hypothesis of Zinsser was confirmed with works of Price (1955) which allocated two strains of rickettsiae of Provachek from inguinal lymph nodes of the died people who had a sapropyra 20 flyings ago. Further endogenous genesis of a "repeated" sapropyra was proved also by numerous researches of other scientists by allocation of rickettsiae of Provachek from fabrics and bodies (lymph nodes, a spleen, marrow, etc.) the people who transferred an epidemic sapropyra in the past.
In experiments on animals the possibility of long preservation of some types, rickettsiae in a live organism is proved. So, at infection of mice of R. orientalis activators can be found in their organism during 3 flyings. Unfortunately, experimentally recurrent hypothesis of Brill cannot be confirmed as preservation of rickettsiae of Provachek in a latent state in an organism of laboratory animals does not manage to be reproduced.
According to WHO recommendations separate statistical account of two forms of a sapropyra — an epidemic sapropyra and recurrent is kept. In honor of the first researchers the recurrent sapropyra can be registered also under other names — "Brill's illness", "Brill's illness — Tsinssera" that corresponds to the International classification of diseases.

Relevance.

The persons who transferred an epidemic sapropyra in the past for many years remain the reservoir of a rickettsial infection and pose potential threat of emergence of epidemic flashes of a sapropyra, especially at untimely identification of cases of an illness of Brill, existence of a pediculosis. The illness Shaved continues to remain among those infections concerning which the program of WHO for epidemic supervision and active identification of patients as dangerous sources of epidemic distribution of diseases is carried out.


 
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