Typhus Fever

Typhus fever is an illness also known as "murine typhus," "endemic typhus," or "flea-borne typhus" that is caused by the bacterium Rickettsia typhi. It is spread through contact with infected fleas—usually through contact with small mammals that have fleas. People get sick with murine typhus when infected flea poop is rubbed into cuts or scrapes in the skin. It is also possible, but less common, to get sick from breathing in infected, dried flea poop.

Murine typhus cannot be spread from one person to another. Once someone has had murine typhus, that person will not become re-infected after they recover.

Due to the effect of climate on fleas, murine typhus cases are very rare in Wisconsin, and all reported cases have been associated with travel outside of the state. Most U.S. cases are reported in people from (or people who have traveled to) California, Hawaii, or Texas. Cat fleas found on cats and opossums have been linked with cases of murine typhus in the U.S. In most other parts of the world, rats are the main animal host for fleas infected with murine typhus.

Typhus Fever 101

Cat looking upwards

 Signs and Symptoms

Symptoms of murine typhus start within two weeks after contact with infected fleas. Signs and symptoms often vary and may include:

  • Fever (in almost all cases) and chills
  • Body aches and muscle pain
  • Loss of appetite
  • Nausea
  • Vomiting
  • Stomach pain
  • Cough
  • Rash (usually occurs around day 5 of illness)

Symptoms of murine typhus can mirror other illnesses. If you have these symptoms, contact your doctor and be sure to mention any travel or contact with animals.

 Treatment

  • Murine typhus can be treated with the antibiotic doxycycline in both adults and children. People who are treated early with doxycycline usually recover more quickly than people left untreated.
  • Antibiotics are most effective when started as soon as possible after symptoms start.
  • Most people will recover without treatment, but some cases may be severe. When left untreated, severe illness can cause damage to one or more organs, including the liver, kidneys, heart, lungs, and brain.

 Prevention

  • Reduce your risk of getting murine typhus by avoiding contact with fleas.
  • There is no vaccine to prevent murine typhus.
  • Keep rodents and animals away from your home, workplace, and recreational areas. Remove brush, rock piles, junk, cluttered firewood, and food supplies, especially pet food.
  • Always wear gloves if you are handling sick or dead animals.
  • Use Environmental Protection Agency (EPA)-registered insect repellent labeled for use against fleas if you think you could be exposed to fleas during activities such as camping, hiking, or working outdoors.
  • Treat clothing and gear with permethrin or purchase permethrin-treated items.
  • Keep fleas off of your pets. Use veterinarian-approved flea control products for cats and dogs, such as flea collars or spot-ons. This is especially important when traveling with pets, adopting pets from other states, or having contact with stray animals.

 Resources

  • Murine Typhus: CDC page with general information on signs and symptoms, diagnosis and testing, treatment, and prevention.

Provider Information

 Reporting and Surveillance Guidance

This is a Wisconsin disease surveillance category II disease:

Wisconsin case reporting and public health follow-up guidelines:

Rickettsiosis (other than spotted fever rickettsioses) EpiNet, P-02251 (PDF): Rickettsiosis (other than spotted fever rickettsioses) case reporting and investigation protocol for health professionals

 Provider Resources

Typhus Fevers Information for Health Care Providers: CDC page with information on clinical characteristics, diagnosing, laboratory confirmation, and treatment.

Last Revised: September 12, 2019