Typhus is an infectious disease which is transmitted by lice or fleas and characterized by high fever , a transient rash , and fairly severe illness.
Alternative Names
Murine typhus; Epidemic typhus; Endemic typhus; Brill-Zinsser disease; Jail fever
Causes, incidence, and risk factors
Typhus is a rickettsial disease caused by one of two organisms, Rickettsia prowazekii (epidemic typhus and Brill disease) and Rickettsia typhi (murine or endemic typhus). Epidemic typhus and Brill disease are uncommon in the United States. Murine typhus occurs in the southeastern and southern states. There are less than 100 cases per year. Murine typhus is a milder form and is seldom fatal (less than 2%). It is frequently seen in the summer and fall and typically lasts two to three weeks. Risk factors for murine typhus include exposure to rat fleas or rat feces, or exposure to other animals (such as cats, opossums, raccoons, skunks, and rats). Epidemic typhus occurs in poor hygienic conditions (which is why it is sometimes called "jail fever"), usually when the temperature is cold. It is spread by lice. Although very rare in the United States, it has sometimes been spread by the lice and fleas of flying squirrels. Brill-Zinsser disease is a mild form of epidemic typhus, caused by reactivation of the disease in the body of someone who has been previously infected after a long period of dormancy. This is more common in the elderly.
Treatment
The goal of treatment is to eliminate the infection and to treat the symptoms with antibiotics (such as tetracycline, doxycycline, or chloramphenicol). For epidemic typhus, intravenous fluids and oxygen may be necessary to help stabilize the patient.
Note: Oral tetracycline is usually not prescribed for children until after all the permanent teeth have erupted. It can permanently discolor teeth that are still forming.
Expectations (prognosis)
Without treatment death may occur in 10 to 60% of patients with epidemic typhus. Patients over the age of 60 have the highest risk of death. With timely antibiotic therapy, the affected person is expected to recover completely. Less than 2% of untreated patients with murine typhus may die, and appropriate antibiotic therapy will cure virtually all patients.
Calling your health care provider
Call your health care provider if symptoms of any type of typhus develop. This serious disorder can require emergency care.
Prevention
Avoid areas where rat fleas or lice might be encountered. Good sanitation and public health measures reduce the rat population.