Typhus Fever With a Report of Cases

Paullin, James E.

doi:10.1097/00007611-191301000-00018

Cited by 13 publications

(3 citation statements)

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“…In the early part of the 20th century, in North America, it was recognized that there existed an illness that resembled louse-borne epidemic typhus, but unlike the classic form, it was milder and did not occur in large outbreaks [40][41][42]. The lack of household clustering, occurrence during warmer weather, lack of associated body louse infestations, and the apparent link to food stuffs led to the hypothesis that the disease centered around rodents and their ectoparasites [43].…”

Section: Ecology Of An Emerging and Reemerging Infectionmentioning

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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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: Ecology Of An Emerging and Reemerging Infectionmentioning

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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“…In 1913, Dr. James Paullin of Grady Hospital in Atlanta, GA was the first to report FBT in the United States; he diagnosed seven cases, based on the fever curves, rashes, negative blood cultures, and negative serologic tests for typhoid ( Figure 1) [76]. Shortly thereafter, cases were recognized in Savannah and Augusta, GA, and later in Montgomery and Mobile, AL, and Jacksonville, FL [77].…”

Section: The Epidemiology and Ecology Of Flea-borne Typhus Is Deducedmentioning

confidence: 99%

History, Rats, Fleas, and Opossums: The Ascendency of Flea-Borne Typhus in the United States, 1910–1944

Anstead

2020

TropicalMed

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Flea-borne typhus, due to Rickettsia typhi and Rickettsia felis, is an infection causing fever, headache, rash, hepatitis, thrombocytopenia, and diverse organ manifestations. Although most cases are self-limited, 26%-28% have complications and up to one-third require intensive care. Flea-borne typhus was recognized as an illness similar to epidemic typhus, but having a milder course, in the Southeastern United States and TX from 1913 into the 1920s. Kenneth Maxcy of the US Public Health Service (USPHS) first described the illness in detail and proposed a rodent reservoir and an arthropod vector. Other investigators of the USPHS (

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“…The bacterium was discovered in Americans. The first suspected case was reported in 1913 in Atlanta [ 2 ]. Its flea-borne route of transmission was realized by a series of experiments, including for endemic typhus, which could be established in guinea pigs with brain emulsions of wild rats, and pulverized flea taken from wild rats in Mexico and the USA during the 1930s [ 3 – 6 ].…”

Section: Introductionmentioning

confidence: 99%

Delayed correlation between the incidence rate of indigenous murine typhus in humans and the seropositive rate of Rickettsia typhi infection in small mammals in Taiwan from 2007–2019

Chiang

Yang

et al. 2022

PLoS Negl Trop Dis

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Murine typhus is a flea-borne zoonotic disease with acute febrile illness caused by Rickettsia typhi and is distributed widely throughout the world, particularly in port cities and coastal regions. We observed that murine typhus was an endemic disease (number of annual indigenous cases = 29.23±8.76) with a low incidence rate (0.13±2.03*10−4 per 100,000 person-years) in Taiwan from 2007–2019. Most (45.79%, 174/380) indigenous infections were reported in May, June, and July. The incidence rates in both May and June were statistically higher than those in other months (p<0.05). Correspondingly, sera collected from small mammals (rodents and shrews) trapped in airports and harbors demonstrated anti-R. typhi antibody responses (seropositive rate = 8.24±0.33%). Interestingly, the ports with the highest seropositivity rates in small mammals are all inside/near the areas with the highest incidence rates of indigenous murine typhus. In addition, incidence rates in humans were positively correlated with the 1-month and 2-month prior seropositive rates in small mammals (R = 0.31 and 0.37, respectively). As early treatment with appropriate antibiotics for murine typhus could effectively shorten the duration of illness and reduce the risk of hospitalization and fatality, flea-related exposure experience should be considered in clinics during peak seasons and the months after a rise in seropositivity rates in small mammals. Surveillance in small mammals might be helpful for the development of real-time reporting or even early reminders for physicians of sporadic murine typhus cases based on the delayed correlation observed in this study.

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Typhus Fever With a Report of Cases

Cited by 13 publications

References 0 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

History, Rats, Fleas, and Opossums: The Ascendency of Flea-Borne Typhus in the United States, 1910–1944

Delayed correlation between the incidence rate of indigenous murine typhus in humans and the seropositive rate of Rickettsia typhi infection in small mammals in Taiwan from 2007–2019

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