Typhus
Definition
Typhus is a bacterial disease spread by lice or fleas.
Alternative Names
Murine typhus; Epidemic typhus; Endemic typhus; Brill-Zinsser disease; Jail fever
Causes, incidence, and risk factors
Typhus is caused by one of two types of bacteria: Rickettsia typhi or Rickettsia prowazekii. The form of typus depends on which type of bacteria causes the infection.
Rickettsia typhi causes murine or endemic typhus. Endemic typhus is uncommon in the United States. It is usually seen in areas where hygiene is poor and the temperature is cold. Endemic typhus is sometimes called "jail fever."
Murine typhus occurs in the southeastern and southern United States, often during the summer and fall. It is rarely deadly. Risk factors for murine typhus include:
Exposure to rat fleas or rat feces
Exposure to other animals (such as cats, opossums, raccoons, skunks, and rats)
Rickettsia prowazekii causes epidemic typhus and Brill-Zinsser disease. Brill-Zinsser disease is a mild form of epidemic typhus. It occurs when the disease re-activates in a person who was previously infected. It is more common in the elderly. Lice and fleas of flying squirrels spread the bacteria.
References
Bechah Y, Capo C, Mege JL, Raoult D. Epidemic typhus. Lancet Infect Dis. 2008;8:417-426.
Review Date: 3/18/2011
Reviewed By: A.D.A.M. Editorial Team: David Zieve, MD, MHA, and David R. Eltz. Previously reviewed by Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital (9/15/2010).
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Murine typhus; Epidemic typhus; Endemic typhus; Brill-Zinsser disease; Jail fever
Symptoms
Symptoms of murine or endemic typhus may include:
- Abdominal pain
- Backache
- Diarrhea
- Dull red rash that begins on the middle of the body and spreads
- Extremely high fever (105 - 106 degrees Fahrenheit), which may last up to 2 weeks
- Hacking, dry cough
- Headache
- Joint and muscle pain
- Nausea
- Vomiting
Symptoms of epidemic typhus may include:
Chills
Cough
High fever (104 degrees Fahrenheit)
Joint pain (arthralgia)
Lights that appear very bright; light may hurt the eyes
Rash that begins on the chest and spreads to the rest of the body (except the palms of the hands and soles of the feet)
Severe headache
- Severe muscle pain (myalgia)
- Stupor
The early rash is a light rose color and fades when you press on it. Later, the rash becomes dull and red and does not fade. People with severe typhus may also develop small areas of bleeding into the skin (petechiae).
Signs and tests
A complete blood count (CBC) may show anemia and low platelets. Other blood tests for typhus may show:
References
Bechah Y, Capo C, Mege JL, Raoult D. Epidemic typhus. Lancet Infect Dis. 2008;8:417-426.
Review Date: 3/18/2011
Reviewed By: A.D.A.M. Editorial Team: David Zieve, MD, MHA, and David R. Eltz. Previously reviewed by Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital (9/15/2010).
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Murine typhus; Epidemic typhus; Endemic typhus; Brill-Zinsser disease; Jail fever
Treatment
Treatment includes antibiotics such as:
Tetracycline taken by mouth can permanently stain teeth that are still forming. It is usually not prescribed for children until after all of their permanent teeth have grown in.
Patients with epidemic typhus may need intravenous fluids and oxygen.
Expectations (prognosis)
Without treatment, death may occur in 10 - 60% of patients with epidemic typhus. Patients over age 60 have the highest risk of death. Patients who receive treatment quickly should completely recover.
Less than 2% of untreated patients with murine typhus may die. Prompt antibiotic treatment will cure nearly all patients.
Complications
Calling your health care provider
Call your health care provider if you develop symptoms of typhus. This serious disorder can require emergency care.
References
Bechah Y, Capo C, Mege JL, Raoult D. Epidemic typhus. Lancet Infect Dis. 2008;8:417-426.
Review Date: 3/18/2011
Reviewed By: A.D.A.M. Editorial Team: David Zieve, MD, MHA, and David R. Eltz. Previously reviewed by Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital (9/15/2010).
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Murine typhus; Epidemic typhus; Endemic typhus; Brill-Zinsser disease; Jail fever
Prevention
Avoid areas where you might encounter rat fleas or lice. Good sanitation and public health measures reduce the rat population.
Measures to get rid of lice when an infection has been found include:
Bathing
Boiling clothes or avoiding infested clothing for at least 5 days (lice will die without feeding on blood)
Using insecticides (10% DDT, 1% malathion, or 1% permethrin)
References
Bechah Y, Capo C, Mege JL, Raoult D. Epidemic typhus. Lancet Infect Dis. 2008;8:417-426.
Review Date: 3/18/2011
Reviewed By: A.D.A.M. Editorial Team: David Zieve, MD, MHA, and David R. Eltz. Previously reviewed by Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital (9/15/2010).
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Review Date: 3/18/2011
Reviewed By: A.D.A.M. Editorial Team: David Zieve, MD, MHA, and David R. Eltz. Previously reviewed by Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital (9/15/2010).
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.