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Published Date: 2011-09-17 11:41:26
Subject: PRO/AH/EDR> Murine typhus - USA (03): (CA)
Archive Number: 20110917.2831

MURINE TYPHUS - USA (03): (CALIFORNIA)
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Date: 14 Sep 2011
Source: The Orange County Register [edited]
http://healthyliving.ocregister.com/2011/09/14/flea-borne-again-a-problem-in-o-c/38358/

A total of 5 people in Orange County [O.C.], including one under 18,
have been diagnosed with confirmed or probable infections caused by
flea-borne typhus during the past 3 months, the county's Health Care
Agency [HCA] reported Wednesday [14 Sep 2011].

Symptoms include fever, headache, muscle aches and a rash on the
chest, back, arms or legs. The disease is treatable with antibiotics,
but it can be fatal if left untreated, says Michael Hearst, district
manager for the county's Vector Control. The disease, also known as
endemic typhus, isn't passed from person to person. Instead, it's
transmitted by the bites of infected fleas. In most of the O.C. cases
the past few years, people have been infected by a family cat,
although other animals can carry the fleas, including rats, opossums
and raccoons. "Everybody we talked to had adopted a feral cat, or had
a cat that was in and out a lot," Hearst said.

"Between 1994 and 2005, there were no reported cases of flea-borne
typhus in the county. There was one case in 2006, 6 in 2007, 15 in
2008, and 6 cases each in 2009 and 2010. We've had more cases in the
last 3 years than in the previous 50," Hearst said. There have been 8
reported cases in 2011. Of the 5 in the last 3 months, 4 were adults
and one was under 18, HCA said. All live in North County, although
infected animals can be found in any part of the county.

What can people do to protect themselves from flea-borne typhus? Here
are some tips offered by HCA:
- Treat pets regularly with flea-prevention medications.
- Avoid contact with rodents, opossums, feral cats or other animals
that may have fleas.
- Close openings to attics and crawl spaces in your home, and keep
vents and screens in good repair to prevent animals from getting in.
- Report dead animals to your local Animal Control agency. OC Animal
Care covers 17 O.C. cities, as well as unincorporated areas. For other
cities, consult the OCAC website, http://www.OCPetInfo.com.
- Remove or trim overgrown vegetation or ground cover where wild
animals may hide or nest.
- Keep trashcans covered, and remove outdoor sources of food and
water, like pet food and fallen fruit from trees.

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[The following is extracted from ProMED-mail post Murine typhus - USA:
(TX) 20110607.1734:

"Murine typhus, which occurs throughout the world, is a flea-borne
rickettsial disease caused by the _Rickettsia typhi_. Rats are the
primary animal reservoir of _R. typhi_; however, other mammals, such
as free-ranging cats, dogs, and opossums and their fleas can maintain
this microorganism in areas where rats and rat fleas are absent (Azad
AF, Radulovic S, Higgins JA, et al: Flea-borne rickettsioses: ecologic
considerations. Emerg Infect Dis 1997; 3(3): 319-27; available at
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2627639/).

"Humans are usually infected by contact with infected flea feces,
either by inoculation into excoriated fleabites, inhalation, or
ingestion. Symptoms include fever, headache, chills, vomiting, nausea,
myalgias, and rash. The illness usually resolves within 3 weeks, even
if untreated. However some patients are sick enough to be hospitalized
in an intensive care unit and up to 4 percent of hospitalized patients
will die from the infection. Treatment is doxycycline. Prevention is
directed at control of flea vectors and animal reservoirs.

"Murine typhus occurs in the USA in southern Texas, southern
California, and Hawaii. In 2008, 33 laboratory-confirmed cases of
murine typhus occurred in Austin, Texas (see ProMED-mail post Murine
typhus - USA (04): (TX) 2008-2009 20091120.3995). Illness ranged from
mild to severe, with 73 percent of patients requiring hospitalization.
Environmental investigation at the time suggested that opossums and
domestic animals likely played a role in the maintenance and spread of
_R. typhi_."

Orange County is a county in the U.S. state of California. As of the
2010 census, its population was 3 010 232, making it the 3rd most
populous county in California, behind Los Angeles County and San Diego
County and the 6th most populous county in the United States as of
2009 (http://en.wikipedia.org/wiki/Orange_County,_California). The
county is known for its tourism. It is the home of such attractions as
Disneyland. The county can be located on a map at
http://en.wikipedia.org/wiki/File:Map_of_California_highlighting_Orange_County.svg
and the state of California can be located on the
HealthMap/ProMED-mail interactive map at
http://healthmap.org/r/008X. - Mod.ML]

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