Cluster of Sylvatic Epidemic Typhus Cases Associated with Flying Squirrels, 2004–2006

Abstract

Infected persons had slept in an infested cabin.

Brill‐Zinsser Disease in a Patient Following Infection with Sylvatic Epidemic Typhus Associated with Flying Squirrels

“…Infection with R. prowazekii continues to be sporadically reported in the United States in association with exposure to flying squirrels [5,6]. Although no fatal cases have been reported to date in association with sylvatic typhus, severe cases requiring hospitalization and intensive care have occurred, and it is presumed that these infections carry the potential for fatal outcome if not recognized and promptly treated.…”

“…There have been at least 47 cases documented in humans since 1976 (Centers for Disease Control and Prevention, unpublished data) [5,6]. Most of these cases had reported contact prior to illness onset with the southern flying squirrel, Glaucomys volans, which serves as a zoonotic reservoir for a sylvatic cycle of infection [5,6].…”

Rickettsia Species: Rickettsioses

“…Studies of the survival of R. prowazekii in louse feces have shown viability over several weeks [44]. More recently, R. prowazekii has been detected both in African ticks and in flying squirrels in the United States [40,98]. Indeed, cases of sylavatic infection have been reported following contact with flying squirrels (and possibly their fleas) [98].…”

“…After decades, a recrudescence of typhus can occur in patients with the potential of transmission to lice and the initiation of a new epidemic occurrence of typhus. The detection of a natural reservoir of R. prowazekii in North American squirrels (Glaucomys volans) implies another mode of persistence in nature and a potential for re-occurrence of epidemic typhus under favorable circumstances for the pathogen [104,105].…”

Sylvatic Typhus Associated with Flying Squirrels (Glaucomys volans) in New York State, United States

“…S ylvatic typhus is an uncommon and potentially fatal zoonotic disease caused by the rickettsial organism Rickettsia prowazekii, which is maintained through an enzootic cycle involving southern flying squirrels (Glaucomys volans) and their ectoparasites (McDade et al 1980, Chapman et al 2009). Although the exact mode of transmission remains unknown, humans in the United States may be exposed to R. prowazekii through bites from infected lice or fleas associated with flying squirrels and their nesting material, by inhaling dried louse feces, or by inadvertently rubbing rickettsia-laden louse feces in the eyes, mucosal membranes, or insect bite-associated wounds (Bechah et al 2008, Chapman et al 2009).…”