The Epidemiology of Murine Typhus in Texas, 1969

Older, Jules

doi:10.1001/jama.1970.03180110021004

Cited by 27 publications

(14 citation statements)

References 6 publications

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“…When murine typhus made an apparent reappearance in Galveston, we could not help but wonder if the alternate cycle of transmission had a role in its reemergence. After all, opossums and C. felis fleas have been linked to cases of murine typhus in a city with longstanding endemicity (Corpus Christi, TX) 11,12 and in a city with a recent outbreak (Austin, TX) 5 -both of which are only 220 miles from Galveston.…”

Section: Discussionmentioning

confidence: 99%

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Opossums and Cat Fleas: New Insights in the Ecology of Murine Typhus in Galveston, Texas

Blanton

Idowu

Tatsch

et al. 2016

The American Society of Tropical Medicine and Hygiene

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Abstract. Murine typhus is an acute undifferentiated febrile illness caused by Rickettsia typhi. The classic reservoir (Rattus spp.) and flea vector (Xenopsylla cheopis) were once culprits of murine typhus in the United States. Vector and rodent control efforts have drastically decreased the prevalence of disease, except in a few endemic foci where opossums and cat fleas play a role in transmission. Since 2012, there has been a reemergence of murine typhus in Galveston, TX. We hypothesize that opossums and cat fleas are involved in the transmission of R. typhi in Galveston. To explore this, we sought to find the seroprevalence of typhus group antibodies from opossums. We also sought to find the prevalence of R. typhi in fleas parasitizing these animals. We collected blood from 12 opossums and found that eight (66.7%) had the presence of anti-R. typhi antibodies. All opossums were infested with fleas; a total of 250 Ctenocephalides felis fleas were collected from these animals. Seven opossums (53.8%) were infested with fleas that had molecular evidence of R. typhi infection, while six (46.2%) were infested with fleas that contained Candidatus Rickettsia senegalensis, an organism closely related to R. felis. The minimum flea infection rate for R. typhi was 7.0%. The minimum infection rate for Candidatus R. senegalensis was 6.1%. Our study demonstrates that fleas infected with R. typhi parasitize opossums in Galveston. It is therefore likely that opossums and their fleas play a role in the city's recent reemergence of murine typhus.

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Section: Discussionmentioning

confidence: 99%

“…In Galveston, after decades of apparent disease quiescence following the control of rat fleas with DDT, 11,12 two cases of murine typhus were diagnosed in 2012 with an additional 12 patients in 2013. 4 Since this reemergence, murine typhus has continued to affect residents of Galveston County (L. Blanton, unpublished data).…”

Section: 10mentioning

confidence: 99%

Opossums and Cat Fleas: New Insights in the Ecology of Murine Typhus in Galveston, Texas

Blanton

Idowu

Tatsch

et al. 2016

The American Society of Tropical Medicine and Hygiene

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“…However, in 1946, as part of an ectoparasite eradication program, the insecticide DDT was applied to common rat paths; subsequently, the number of ectoparasites spread by rats in human habitats was reduced. As a result, the incidence of murine typhus in Galveston decreased dramatically ( 2 ) and continued to decline through subsequent decades ( 11 ). This study describes what is probably the reemergence of murine typhus in this area.…”

Section: Discussionmentioning

confidence: 99%

Reemergence of Murine Typhus in Galveston, Texas, USA, 2013

Blanton¹,

Vohra²,

Bouyer³

et al. 2015

Emerg. Infect. Dis.

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“…Efforts to decrease the burden of rat ectoparasites by intensive dusting with DDT virtually eliminated this disease [2, 3]. Although the southern counties of Texas and California currently report the greatest number of murine typhus cases in the United States, the disease is still uncommonly diagnosed.…”

Section: Discussionmentioning

confidence: 99%

“…This situation makes a definitive diagnosis during the acute stage of illness difficult to establish [1]. Although control of the flea vectors can effectively control the burden of human disease [2, 3], the peridomestic invasion of reservoir hosts (e.g., rats and opossums) places people at risk for disease [4–6]. We herein report a case of murine typhus in an area where the broad use of DDT in the mid-20th century made it a rare disease [2, 3].…”

Section: Introductionmentioning

confidence: 99%

Murine Typhus: An Important Consideration for the Nonspecific Febrile Illness

Basra

Berman

Blanton

2012

Case Reports in Medicine

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Murine typhus is a widely distributed flea-borne infection caused by Rickettsia typhi. Symptoms of murine typhus are nonspecific and mimic a variety of other infectious diseases. We herein report a case of murine typhus in an area where the broad use of DDT in the mid-20th century has now made it a rare disease. The patient described presented with headache, fever, and a faint macular rash. Initial laboratory studies revealed a slight transaminase elevation. Further questioning revealed exposure to opossums, prompting the consideration of murine typhus as a diagnosis. Although typhus group antibodies were not present during the patient's acute illness, empiric therapy with doxycycline was initiated, and the patient defervesced. One month after convalescence, the patient returned to clinic with serum that contained typhus group antibodies with an IgG titer of 1 : 1024. Murine typhus is an important consideration during the workup of a patient with a nonspecific febrile illness. Exposure to reservoir hosts and the flea vector place humans at risk for this disease. Clinician recognition of this entity is required for diagnosis and effective therapy.

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The Epidemiology of Murine Typhus in Texas, 1969

Cited by 27 publications

References 6 publications

Opossums and Cat Fleas: New Insights in the Ecology of Murine Typhus in Galveston, Texas

Opossums and Cat Fleas: New Insights in the Ecology of Murine Typhus in Galveston, Texas

Reemergence of Murine Typhus in Galveston, Texas, USA, 2013

Murine Typhus: An Important Consideration for the Nonspecific Febrile Illness

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