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Alternative NamesMurine typhus; Epidemic typhus; Endemic typhus; Brill-Zinsser disease; Jail fever
Definition Return to top
Typhus is a bacterial disease spread by lice or fleas.
Causes Return to top
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." Lice and fleas of flying squirrels spread the bacteria.
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:
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.
Symptoms Return to top
Symptoms of murine typhus may include:
Symptoms of endemic typhus may include:
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).
Exams and Tests Return to top
A complete blood count (CBC) may show anemia and low platelets. Other blood tests for typhus may show:
Treatment Return to top
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.
Outlook (Prognosis) Return to top
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.
Possible Complications Return to top
When to Contact a Medical Professional Return to top
Call your health care provider if you develop symptoms of typhus. This serious disorder can require emergency care.
Prevention Return to top
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:
References Return to top
Bechah Y, Capo C, Mege JL, Raoult D. Epidemic typhus. Lancet Infect Dis. 2008;8:417-426.Update Date: 9/28/2008 Updated by: Jatin M. Vyas, PhD, MD, Instructor in Medicine, Harvard Medical School, Assistant in Medicine, Division of Infectious Disease, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.