Typhus

What is Typhus?

Typhus is a disease caused by rickettsia or orientia bacteria. You can get it from infected mites, fleas, or lice.

Modern hygiene has mostly stopped typhus, but it can still happen in places where basic sanitation is bad or if it gets passed on by an infected animal.

There are three main kinds of typhus, each caused by different bacteria.

  • Murine typhus is passed by fleas to people if the fleas bite infected animals, mainly rats. Most U.S. cases have been reported in California, Hawaii, and Texas.
  • Epidemic typhus is a rare variety spread by infected body lice. It’s unlikely to happen outside of extremely crowded living conditions. One type of epidemic typhus can be spread by infected flying squirrels. But it, too, is very rare.
  • Scrub typhus is spread by infected chiggers, or mites, mainly found in rural parts of Southeast Asia, China, Japan, India, and northern Australia.

Doctors can easily treat all three kinds of typhus with antibiotics. But they can cause serious illness, so get treatment right away if you think you might have been exposed to it.

Typhus Symptoms

With any kind of typhus, you’ll start to feel ill about 10 days to 2 weeks after the typhus bacteria get into your body. You’ll likely have:

With murine typhus, you may also have:

With epidemic typhus, you could notice:

  • Confusion
  • Coughing
  • Fast breathing
  • Nausea
  • Vomiting

Other symptoms of scrub typhus include:

  • Confusion or other mental impairment
  • A dark scab on the area where the chigger bit you
  • Swollen lymph nodes

Typhus Causes

Insects and other parasites spread murine and epidemic typhus when they bite you and leave bacteria-laden feces on your skin.

  • When you scratch the itching bug bite, you can spread the infected feces into the open bite wound or other cuts on your skin’s surface. That moves the typhus bacteria into your bloodstream.
  • You can get scrub typhus if a mite infected with the bacterium bites you, even if you don’t scratch the bite.

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Typhus Diagnosis

If your doctor thinks you have typhus, you’ll get a blood test to check for typhus bacteria, especially if you’ve traveled to an area where typhus is common.

It can sometimes take weeks to get those blood test results. So the doctor may recommend you start antibiotic treatment right away to be safe.

Typhus Treatment

The most effective therapy for all three kinds of typhus is the antibiotic doxycycline.

  • A single dose of doxycycline has proved effective against epidemic typhus. Doxycycline also works quickly on other strains of the disease.
  • For the best results, you should take it as soon as possible after your symptoms start.
  • If you’re allergic to doxycycline or if it doesn’t work, doctors may choose another antibiotic such as ciprofloxacin (Cipro).

Typhus Complications

If you don’t treat it, typhus can cause serious and even deadly complications. They include:

Typhus Prevention

There’s no vaccine that can protect you from typhus. But you can take steps to avoid it:

  • Basic hygiene helps. This includes very simple things like bathing at least once a week and changing your clothes on a regular basis.
  • Keep a safe distance from wild animals known to carry typhus, like rats, flying squirrels, and opossums. Don’t leave food waste or other trash in your yard where it could attract them.
  • For murine typhus protection, spray flea control products on your furry pets and in your yard, and don’t let your pets share your bed.
  • If you travel to places where murine typhus or scrub typhus are found, use an insect repellent that contains 20% to 30% DEET.

WebMD Medical Reference Reviewed by Neha Pathak, MD on September 28, 2020

Sources

SOURCES:

Lancet: “Orientia, Rickettsia, and Leptospira Pathogens as Causes of CNS Infections in Laos: A Prospective Study.”

CDC: “Typhus Fevers,” “Epidemic Typhus,” “Murine Typhus,” “Scrub Typhus.”

Emerging Infectious Diseases: “Cluster of Sylvatic Epidemic Typhus Cases Associated With Flying Squirrels, 2004-2006.”

County of Los Angeles Public Health: “Flea-Borne (Endemic) Typhus,” “Flea-Borne Typhus: Get Protected,” “Protect Yourself & Your Neighbors From Flea-Borne Typhus.”

Clinical Laboratory Science: “Murine Typhus: Endemic Rickettsia in Southwest Texas.”

Merck Manual: “Epidemic Typhus,” “Scrub Typhus.”

California Department of Public Health: “Typhus (Flea-Borne).”

Indian Journal of Dermatology: “Scrub Typhus: An Emerging Threat.”

Postgraduate Medical Review: “Rickettsial Diseases: The Typhus Group of Fevers -- A Review.”

Emerging Infectious Diseases: “Acute Febrile Illness and Complications Due to Murine Typhus, Texas, USA.”

Chemotherapy: “Single-Dose Treatment of Epidemic Typhus With Doxycycline.”

Austin Public Health: “Typhus.”

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