Increased Seroprevalence of Typhus Group Rickettsiosis, Galveston County, Texas, USA

Blanton, Lucas S.; Martinez, Maria A Caravedo; Mendell, Nicole L.; Villasante‐Tezanos, Alejandro; Walker, David H.; Bouyer, Donald H.

doi:10.3201/eid2901.221206

Cited by 4 publications

(4 citation statements)

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“…In North America, cases are recognized in Mexico [92,93] and in the U.S. states of Hawaii, California, and Texas [94][95][96]. There has been an alarming increase in California, with foci around homeless encampments, and in Texas, where the distribution of disease is moving northward [33,96,97]. The increased recognition of cases in Southern California, Texas, Mexico, and South America highlights the reemergence of the pathogen in these regions.…”

Section: Epidemiology Of An Underrecognized and Reemerging Cause Of I...mentioning

confidence: 99%

“…Thus, the presence of reactive antibodies may reflect a previous illness. In Galveston County, Texas, and on Honshu Island, Japan, seroprevalence studies have demonstrated a seroprevalence of 7.8% and 7.7% at titers of at ≥1:128 and ≥1:160, respectively [76,97]. Thus, in areas where the disease is endemic, there may be a substantial seroprevalence within the population.…”

Section: Diagnosismentioning

confidence: 99%

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Murine Typhus: A Review of a Reemerging Flea-Borne Rickettsiosis with Potential for Neurologic Manifestations and Sequalae

Blanton

2023

Infectious Disease Reports

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Murine typhus is an acute febrile illness caused by Rickettsia typhi, an obligately intracellular Gram-negative coccobacillus. Rats (Rattus species) and their fleas (Xenopsylla cheopis) serve as the reservoir and vector of R. typhi, respectively. Humans become infected when R. typhi-infected flea feces are rubbed into flea bite wounds or onto mucous membranes. The disease is endemic throughout much of the world, especially in tropical and subtropical seaboard regions where rats are common. Murine typhus is reemerging as an important cause of febrile illness in Texas and Southern California, where an alternate transmission cycle likely involves opossums (Didelphis virginiana) and cat fleas (Ctenocephalides felis). Although primarily an undifferentiated febrile illness, a range of neurologic manifestations may occur, especially when treatment is delayed. Serology is the mainstay of diagnostic testing, but confirmation usually requires demonstrating seroconversion or a fourfold increase in antibody titer from acute- and convalescent-phase sera (antibodies are seldom detectable in the first week of illness). Thus, early empiric treatment with doxycycline, the drug of choice, is imperative. The purpose of this review is to highlight murine typhus as an important emerging and reemerging infectious disease, review its neurologic manifestations, and discuss areas in need of further study.

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Section: Epidemiology Of An Underrecognized and Reemerging Cause Of I...mentioning

confidence: 99%

Section: Diagnosismentioning

confidence: 99%

Murine Typhus: A Review of a Reemerging Flea-Borne Rickettsiosis with Potential for Neurologic Manifestations and Sequalae

Blanton

2023

Infectious Disease Reports

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“…The higher-than-expected seroreactivity to R. typhi within other endemic and previously endemic areas supports this possibility. 16 , 17 …”

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confidence: 99%

“…The higher-than-expected seroreactivity to R. typhi within other endemic and previously endemic areas supports this possibility. 16,17 The evidence suggesting flea-borne typhus is underrecognized in Southern California has broad implications. Yes, flea-borne typhus has been described as mild, but patients infected with R. typhi tend to disagree with this sentiment.…”

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confidence: 99%

Rickettsia typhi in Southern California: A Growing Flea-Borne Threat

Blanton

2024

The American Journal of Tropical Medicine and Hygiene

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Knowledge and practices related to louse‐ and flea‐borne diseases among staff providing services to people experiencing homelessness in the United States

Rich,

Carpenter,

Dell

et al. 2024

Zoonoses and Public Health

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Background and AimsLouse‐borne Bartonella quintana infection and flea‐borne murine typhus are two potentially serious vector‐borne diseases that have led to periodic outbreaks among people experiencing homelessness in the United States. Little is known about louse‐ and flea‐borne disease awareness and prevention among staff who provide services to the population. We surveyed staff in seven US states to identify gaps in knowledge and prevention practices for these diseases.Methods and ResultsSurveys were administered to 333 staff at 89 homeless shelters and outreach teams in California, Colorado, Georgia, Maryland, Minnesota, New York and Washington from August 2022 to April 2023. Most participants (>68%) agreed that body lice and fleas are a problem for people experiencing homelessness. About half were aware that diseases could be transmitted by these vectors; however, most could not accurately identify which diseases. Less than a quarter of staff could describe an appropriate protocol for managing body lice or fleas. Misconceptions included that clients must isolate or be denied services until they are medically cleared.ConclusionsOur findings reveal significant knowledge gaps among staff who provide services to people experiencing homelessness in the prevention and control of louse‐ and flea‐borne diseases. This demonstrates an urgent need for staff training to both reduce disease and prevent unnecessary restrictions on services and housing.

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Increased Seroprevalence of Typhus Group Rickettsiosis, Galveston County, Texas, USA

Cited by 4 publications

References 10 publications

Murine Typhus: A Review of a Reemerging Flea-Borne Rickettsiosis with Potential for Neurologic Manifestations and Sequalae

Murine Typhus: A Review of a Reemerging Flea-Borne Rickettsiosis with Potential for Neurologic Manifestations and Sequalae

Rickettsia typhi in Southern California: A Growing Flea-Borne Threat

Knowledge and practices related to louse‐ and flea‐borne diseases among staff providing services to people experiencing homelessness in the United States

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