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Trench fever is a moderately serious disease, transmitted by lice, that infected more than a million soldiers during World War I and World War II. The disease persists among the homeless. Outbreaks have been documented, for example, in Seattle and Baltimore among injection-drug users, Marseilles, and Burundi.
Trench fever is also called Wolhynia fever, shin bone fever, quintan fever, five-day fever, Meuse fever, His disease, and His-Werner disease (after Wilhelm His, Jr. and Heinrich Werner).
The disease is caused by the organism Bartonella quintana, found in the gut of the body louse.
The disease is classically a 5-day fever. The onset of symptoms is sudden with high fever, severe headache, back pain and leg pain and a fleeting rash. Recovery takes a month or more. Relapses are common.
Transmission of the disease to people can occur by rubbing feces of infected louse into abraded skin or into the eyes.