Murine typhus Endemic Flea-Borne Typhus Fever

What is Murine typhus?

Endemic flea-borne typhus fever is also known as “murine typhus” or “jail typhus”. It is one of three versions of typhus caused by three different bacteria in the Rickettsia group (i.e, Rickettsia prowazekii, Rickettsia typhi, and Orientsia tsutsugamushi). Endemic flea-borne typhus is caused by Rickettsia typhi. Flea-borne typhus is usually milder than epidemic louse-borne typhus. 

Endemic flea-borne typhus usually occurs in areas with flea-infested rats and poor hygiene in tropical and subtropical environments. The risk to travellers of acquiring endemic flea-borne typhus is low. 

How do you get Murine typhus?

The germs (Rickettsia) that cause murine typhus are transmitted by infected fleas that are usually carried by rats and sometimes dogs and cats.  The infected fleas usually defecate when they bite, and the bacteria in their feces is then rubbed or scratched into the bite or cuts on a person's skin. The infection is not transmitted directly from person to person.

Susceptibility and Resistance

Everyone is susceptible to endemic flea-borne typhus. One attack results in immunity to further infections with this bacteria.

Incubation Period

The incubation period for Murine typhus is 7-14 days.

What are the Symptoms?

Flea-borne typhus illness is very similar to epidemic louse-borne typhus, but the symptoms and the illness are much milder. Symptoms include abdominal pain, backache, diarrhoea, a dull red rash that begins on the middle of the body and spreads, extremely high fever (which may last up to 2 weeks), dry cough, headache, joint and muscle pain, nausea, and vomiting. Usually, less than 1 percent of the cases will die if untreated, so endemic flea-borne typhus is rarely deadly.

Preventative Measures

No vaccines or drugs are available to prevent rickettsial infections.  The best prevention is to avoid rat infested areas.  The proper use of insect repellent and self examination to eliminate any fleas will help reduce the risk.  Travellers who are occupationally exposed to rats (naturalists, geologists, agricultural workers) should avoid rat-infested habitats, use repellents and wear protective clothing.

Treatment

Antibiotic treatment with doxycycline daily for 5-7 days and for an additional 2 days after the fever subsides usually cures the illness.

Medications

Where Does It Commonly Occur?

The germs (rickettsia) that causes flea-borne typhus are widely distributed in the world, especially in tropics and sub-tropics and in port cities and coastal regions with large numbers of rats. Flea-infested rats can be found throughout the year in humid, tropical environments and during the warm summer months in temperate regions. The disease has been reported among travellers in Asia, Africa, southern Europe, as well as the United States (Hawaii, California, and Texas).

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