Murine Typhus

Murine typhus, also called endemic typhus or flea-borne typhus, is a disease caused by a bacteria called Rickettsia typhi. Murine typhus is spread to people through contact with infected fleas. People get sick with murine typhus when infected flea feces are rubbed into cuts or scrapes in the skin. In most areas of the world, rats are the main animal host for fleas infected with murine typhus. Murine typhus occurs in tropical and subtropical climates around the world where rats and their fleas live. Cat fleas found on domestic cats and opossums have been associated with cases of murine typhus in the United States. Most cases of murine typhus in the United States are reported in people from California, Hawaii, and Texas.

Signs and Symptoms

Closeup image of a flea.

Figure 1: Xenopsylla cheopis, the Oriental rat flea

Symptoms of murine typhus begin within 2 weeks after contact with infected fleas. 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)

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.

Diagnosis and Testing

  • The symptoms of murine typhus are similar to symptoms of many other diseases. See your health care provider if you develop the symptoms listed above after coming in contact with fleas.
  • Tell your health care provider if you have had contact with animals including rats, cats, or opossums.
  • Your health care provider may order a blood test to look for murine typhus or other diseases.
  • Laboratory testing and reporting of results can take several weeks, so your health care provider may start treatment before results are available.

Treatment

  • Murine typhus is effectively 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 who are treated early with doxycycline usually recover quickly.

Prevention

  • There is no vaccine to prevent murine typhus.
  • Reduce your risk of getting murine typhus by avoiding contact with infected fleas.
  • 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 repellentExternal labeled for use against fleas if you think you could be exposed to fleas during activities such as camping, hiking, or working outdoors.
    • Products containing DEET can be applied to the skin as well as clothing.
    • Always follow product instructions.
    • Reapply insect repellent as directed.
    • Do not spray repellent on the skin under clothing.
    • If you are also using sunscreen, apply sunscreen before applying insect repellent.
  • If you have a baby or child:
    • Do not use insect repellent on babies younger than 2 months of age.
    • Dress your child in clothing that covers arms and legs, or cover crib, stroller, and baby carrier with mosquito netting.
    • Do not apply insect repellent onto a child’s hands, eyes, or mouth or on cuts or irritated skin.
    • Adults: Spray insect repellent onto your hands and then apply to child’s face.
  • Treat clothing and gear with permethrin or purchase permethrin-treated items.
    • Permethrin kills fleas and can be used to treat boots, clothing, and camping gear.
    • Treated clothing remains protective after multiple washings. See product information to learn how long the protection will last.
    • If treating items yourself, follow the product instructions carefully.
    • Do NOT use permethrin products directly on skin. They are intended to treat clothing.
  • Keep fleas off of your pets. Use veterinarian-approved flea control products for cats and dogs such as flea collars 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.