Typhus

What is Typhus?

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

Modern hygiene has mostly stopped typhus, but it can still happen in conditions 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 -- again, 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.

All three kinds of typhus can cause serious illness, so get immediate treatment if you think you might have been exposed to it.

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 infested feces into the open bite wound or other cuts on your skin’s surface. That deposits 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.

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.

At first, you’ll feel chills, run a fever, and develop a severe headache. You may start to breathe fast and get full-body muscle aches like what you’d have with the flu. Stomach pain and vomiting are common, too.

A few days later, you might notice a spotted rash on your chest and midsection, which often spreads to other parts of your body. With scrub typhus, you might see a dark scab on the area where the chigger bit you.

Complications from untreated typhus can include conditions such as pneumonia, meningitis, or septic shock.

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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 your doctor may recommend you start antibiotic treatment right away to be safe.

Treatment

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

A single dose of doxycycline has proven 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).

Prevention

There is no vaccine that can protect you from typhus. But basic hygiene helps. This includes very simple things like bathing at least once a week and changing your clothes on a regular basis.

You should also keep a safe distance from wild animals known to carry typhus, such as 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, you may also want to 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 Debra Jaliman, MD on November 15, 2018

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.”

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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