The skull depicted in this poster indicates the seriousness with which armies learned treat typhus. Diseases like typhus that spread rapidly in the unsanitary conditions of wartime could quickly become epidemic.
Typhus is carried and spread by a louse that proliferates rapidly in unsanitary, crowded conditions, such as military encampments. Though typhus was first reported among Serbian soldiers fighting the invading Austrian forces, it quickly spread to the civilian population, and in some areas it inflicted mortality rates up to 60%. By January 1915, Serbia was in a state of medical chaos. Many of the areas most affected by typhus were new Serbian territories after the Second Balkan War where governmental administrations had yet to be fully developed. Therefore, there was no governmental oversight to keep the disease from spreading; with no hospitals devoted to infectious diseases, patients known to have typhus were sent back to their homes and villages, only to spread the typhus to their family and neighbors. Many Serbian doctors had traveled to northern Serbia to care for the wounded soldiers fighting Austria-Hungary, leaving typhus patients without proper care. Typhus patients continued to require extensive care even when the disease faded. Those who survived the disease often suffered gangrenous infections as a result, which often required amputation. By mid November, when Lady Paget and her hospital arrived in Skoplje, Serbia, typhus had a strong hold on the population. At the height of the epidemic, as many as 2,500 deaths per day were reported in Serbia. While the Serbian Relief Fund, led by Lady Paget set up typhus hospitals to care for the sick, few measures were in place to halt the spread of the disease. The primary task of the Red Cross American Sanitation Commission was to clean and fumigate Serbia to stem the spread of typhus.
The Red Cross Serbian Relief Fund
Doctors Beyond Borders: Serbian Relief in 1915 
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