Published Date: 2009-06-16 21:00:06
Subject: PRO/AH/EDR> Murine typhus - USA: (TX)
Archive Number: 20090616.2228
MURINE TYPHUS - USA: (TEXAS)
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
Date: Fri 12 Jun 2009
Source: News8 Austin (TX) [edited]
Williamson County and Cities Health District is investigating 3
probable cases of murine typhus, also called fleaborne typhus. In
addition, there have been cases reported in Travis County.
Murine typhus is not spread from person-to-person, it is contracted
from the bites of infected fleas. Those fleas live on rats, mice and
other small animals including cats and dogs. Common symptoms include
high fever, severe headaches, body aches and rash. Some severe cases
of typhus can lead to hospitalization, but the disease is rarely
To prevent the spread of typhus, it is recommended that people:
-- Clean yards so rodents and other animals can't live there (this
includes removing brush, trash and keeping the grass mowed);
-- Do not leave pet food out at night as this attracts other animals;
-- Avoid areas that may be infested with fleas;
-- Use insect repellents containing DEET if your activity could
expose you to fleas;
-- Avoid interaction with feral animals and wildlife.
ProMED-Mail Rapporteur Susan Baekeland
[Among the diseases with typhus literally, or figuratively, in their
names: epidemic typhus, Brill-Zinsser disease (recrudescent epidemic
typhus), murine typhus, scrub typhus, and typhoid (so-called because
it is typhus-like). The term typhus comes from the Greek, _typhein_
-- to smoke -- which may refer to the smoky or clouded mental status
that patients present with.
Murine typhus, caused by _Rickettsia typhi_, is distributed widely
throughout the world, especially in the warm and humid coastal
environments of tropic and subtropical climes. Although clearly
endemic in Texas, the increased number of cases of cases occurred in
2004. In the developed world, the infection is found along the
eastern coasts of the south Atlantic states in the USA, the
Caribbean, the Pacific coasts of the southwestern USA, as well as
Hawaii. In Europe, it is distributed along the Mediterranean coast as
well as the Atlantic and Mediterranean coasts of Africa.
It is a zoonosis, in which rats function as the disease's
asymptomatic reservoir, and the Oriental rat flea _Xenopsylla
cheopis_ is the most common vector. Although generally coastal in
distribution, the disease may well spread away from the coast via
major routes of transportation. Although rickettsia-infected flea
feces being rubbed into a flea bite appears to be the major vehicle
of transmission to man, flea bites themselves, and aerosolization of
flea feces, may transmit infection as well.
Murine typhus is a relatively mild disease. Among patients admitted
to an acute care hospital with this disease, only 10 percent require
intensive care, but 1-4 percent die. Diagnosis is based on serology.
However, identification of rickettsiae in smear or culture of skin
lesions may be performed by specialized laboratories.
The typical adult therapy consists of doxycycline 100 mg twice daily
for 3 to 5 days.
High activity exists in the Rio Grande valley (southern Texas) and in
the Los Angeles area.
In the USA, 19 663 cases were reported during 1944 to 1953 (5401 in
1944); 812 during 1954 to 1963; 315 during 1964 to 1973; 588 during
1974 to 1983. 33 cases were reported from Los Angeles during 1984 to
1988 (cats and opossums implicated as reservoirs); 50 cases
nationwide in 1990; 43 in 1991 (22 in Texas); 28 in 1992 (18 in
Texas); 25 in 1993. As of 1994, the disease was no longer nationally
notifiable. - Mod.LL]