During the German siege of Leningrad (1941–1944), the city's starving population endured not only famine but epidemic disease including louse-borne typhus as sanitary conditions collapsed under bombardment and blockade. The body louse flourished in the desperate conditions of the besieged city, and typhus outbreaks added to the catastrophic mortality from starvation and shelling. The siege killed approximately 800,000 civilians in addition to military losses, making it the deadliest siege in the history of warfare.

The siege of Leningrad was documented and memorialised by some of Russia's greatest poets, most notably Anna Akhmatova, whose Poem Without a Hero was partly written during the siege period, and Olga Berggolts, who broadcast poetry to the city's defenders throughout the blockade. The louse and typhus were part of the biological reality of siege life that these poets addressed indirectly through the imagery of endurance, suffering, and survival. Dmitri Shostakovich's Leningrad Symphony, composed during the siege, stands alongside the poetry as a monument to the experience of biological and military catastrophe combined.