Flea-borne (murine) typhus

Flea-borne (murine) typhus, is a disease caused by a bacteria called Rickettsia typhi. Flea-borne typhus is spread to people through contact with infected fleas. Fleas become infected when they bite infected animals, such as rats, cats, or opossums. When an infected flea bites a person or animal, the bite breaks the skin, causing a wound. Fleas poop when they feed. The poop (also called flea dirt) can then be rubbed into the bite wound or other wounds causing infection. People can also breathe in infected flea dirt or rub it into their eyes. This bacteria is not spread from person to person. Flea-borne typhus occurs in tropical and subtropical climates around the world including areas of the United States (southern California, Hawaii, and Texas). Flea-borne typhus is a rare disease in the United States.

Signs and Symptoms

Closeup image of a flea.

Figure 1: Xenopsylla cheopis, the Oriental rat flea

Symptoms of flea-borne typhus begin within 2 weeks after contact with infected fleas or flea dirt. However, people may not know they have been bitten by a flea or exposed to flea dirt so tell your healthcare provider about time spent outdoors or contact with animals. Signs and symptoms may include:

  • Fever and chills
  • Body aches and muscle pain
  • Loss of appetite
  • Nausea
  • Vomiting
  • Stomach pain
  • Cough
  • Rash (typically occurs around day 5 of illness)

Severe illness is rare and most people recover completely, sometimes without treatment. Untreated disease can cause severe illness and damage to one or more organs, including the liver, kidneys, heart, lungs, and brain.

Diagnosis and Testing

  • The symptoms of flea-borne typhus are similar to symptoms of many other diseases. See your healthcare provider if you develop the symptoms listed above, and be sure to mention contact with fleas, stray animals (such as cats), or wildlife (such as rats or opossums).
  • Your healthcare provider may order a blood test to look for flea-borne typhus or other diseases.
  • Laboratory testing and reporting of results can take several weeks, so your healthcare provider may start treatment before results are available.


  • Flea-borne typhus is treated with the antibiotic doxycycline. Doxycycline can be used in persons of any age.
  • Antibiotics are most effective when given soon after symptoms begin.
  • People treated early with doxycycline usually recover quickly.
  • There is no evidence that persistent or chronic infections occur.


  • There is no vaccine to prevent flea-borne typhus.
  • Reduce your risk of getting flea-borne typhus by avoiding contact with fleas.
  • Keep fleas off of your pets. Use veterinarian-approved flea control products for cats and dogs such as flea collars, oral medication or spot-ons. Permethrin should not be used on cats. Animals that are allowed outside are more likely to come in contact with fleas and could bring them inside.
  • Keep rodents and animals (e.g. opossums) away from your home, workplace, and recreational areas:
    • Store food, including pet food, in tight sealing containers.
    • Remove brush, rock piles, junk, and cluttered firewood outside of your home.
    • Seal up holes in your home where rodents can enter.
    • Keep tight lids on compost and trash cans.
    • The CDC’s rodents website offers helpful suggestions on rodent control during and after a rodent infestation.
  • Protect yourself from flea bites:
    • Do not feed or pet stray or wild animals.
    • Always wear gloves if you are handling sick or dead animals.
    • Use EPA-registered insect repellentsexternal icon on your skin and clothing when spending time outside. Always follow instructions listed on the product label.