Historically tiny little insects and even tinier little bacteria have probably change the course of human history. One article, The History of Epidemic Typhus, discusses typhus infecting armies in Europe states “Epidemic typhus has accompanied disasters that impact humanity and has arguably determined the outcome of more wars than have soldiers and generals.”
The family of bacteria called Rickettsia carry typhus. The one people of southern Texas need to know about is Rickettsia typhi. This tiny little bacteria causes Murine typhus and is spread to people through infected flea bites, both rat and cat fleas. The fleas become infected when they bite infected animals, such as rats, feral cats and opossums. Once the flea is infected, it is infected for life.
The CDC explains that when the infected flea bites a person or animal, the flea breaks the skin. Fleas poop when they feed. When the skin is scratched the infected poop, flea dirt, is rubbed into the skin. People can also breathe in infected flea dirt or rub it in their eyes. Usually it takes one to two weeks for the person to become ill.
In the United States, southern California, Hawaii and southern Texas report the most cases. The number of reported cases has increased significantly in the last two decades. The CDC suggest that murine typhus may be considered as a re-emerging infectious disease in certain areas of the United States because of climate change.
Most people do not know that they have been bitten by a flea or exposed to flea dirt. Risk factors include time spent outdoors or have contact with particular animals, especially rats. These animals may be sick or dead. One should be very careful of dead rats.
Signs/symptoms of murine typhus can include fever and chills, body aches, cough, loss of appetite and vomiting, stomach pain. About half of patients will have a rash in about 5 days. These symptoms are common to many other diseases. It is helpful to know about contact with rodents, stray animals or wildlife. Severe illness can occur but deaths are rare. It cannot be transferred from person to person. Fortunately it is treatable with Doxycycline.
There is no vaccine to prevent murine typhus. Prevention of exposure is the key. Keep fleas off your pets. Use flea control products. (No permethrin on cats.) Keep rodents and wild animals away from your home, workplace, and recreation areas. Store food in tightly sealed containers, remove clutter around the house and seal up holes in your home. Don’t pet or feed wild animals and always wear gloves handling dead animals and wear long pants tucked into socks.
Between 2008 and 2022 Texas had over 5,800 reported cases with 100-250 cases in Galveston County. More than 60% required hospitalization. A lab test is necessary to diagnose and can take a long time. Let your doctor know if you or your family have been exposed to flea dirt and have the above symptoms and are not responding to the usual treatments.
by Sally Robinson, MD, Clinical Professor
Keeping Kids Healthy
Published June 2024