La Valentine disease: An outbreak of exanthematic typhus in Marseille, France, in 1810.

Background: Exanthematic typhus was highly frequent in the early 19th century among military troops and prisoners and at hospitals.

Methods: Based on old reports, we describe an outbreak in a village, in Southern France, in 1810.

Results: Twenty-eight cases were identified, over a period of 10 days following the death of the index case, in a soldier. Symptoms included notably persistent constant fever, myalgia and headaches, gastro-intestinal symptoms, prostration and stupor. Three patients suffered delirium and nine died (31.0%). Overall, symptoms persisted for 13-14 days. A total of 16 cases were secondary to contacts with the index case, and 10 cases were in house-hold contacts of secondary cases. Five familial clusters were described.

Conclusion: This data suggest that exanthematic typhus outbreaks among civilian populations also occurred outside the context of hospitals, in link with introduction of the disease by prisoners or soldiers.