What Is Murine Typhus (Flea-Borne Typhus)?

Flea-borne typhus symptoms appear within two weeks of contact with infected fleas or flea soil. People may not realize they have been bitten by a flea or exposed to flea soil, so inform your healthcare professional about any time spent outside or interaction with animals. 

The most common signs and symptoms of murine typhus include:

• Chills and fever
• Headache
• Muscle pain
• Loss of appetite 
• Nausea and vomiting
• Abdominal pain
• Diarrhea
• Rash (usually seen on the fifth day of the disease)
• Cough
• Confusion

Severe cases of murine typhus are uncommon, and most people recover completely even without active treatment. However, if left untreated, murine typhus can result in serious sickness and organ damage (including the liver, kidneys, heart, lungs, and brain).

The mortality rate for murine typhus is one percent when adequate antibiotics are used and four percent when antibiotics are not used.

A physical examination and thorough information about the symptoms are mostly used to make a diagnosis. You may be questioned if you have ever been bitten by fleas. If your doctor detects typhus, you will be given medications immediately soon.

To confirm the diagnosis, blood tests will be done.

Indirect immunofluorescence antibody assay

Serologic testing for R. typhi IgG and IgM antibodies can be used to make a laboratory diagnosis. Serology conducted within the first week of symptom onset can often be false-negative. 

A matched serology of acute and convalescent samples (taken two weeks later) exhibiting a fourfold increase in IgG titers is required for an R. typhi diagnosis. However, because not all people with murine typhus return for further testing, a possible diagnosis can be made only on a single positive sample with supporting clinical and laboratory evidence.

It is common to find abnormal levels of various serologies in the laboratory findings, such as:

• Increased creatine kinase
• Elevated levels of alanine transaminase and aspartate transaminase
• Increased lactate dehydrogenase, which indicates tissue damage
• Hypoalbuminemia (low albumin protein)
• Hyponatremia (low sodium)
• Thrombocytopenia (low platelet count)

Treatment should last at least five days or until the person becomes afebrile after 48 hours. People suspected to have murine typhus should be treated as soon as possible, rather than waiting for test confirmation.

• Antibiotics are effective in treating flea-borne typhus.
• Doxycycline is the preferred therapy for adults.

There is no vaccination available to protect against flea-borne typhus. The key to avoiding this disease is to avoid contact with fleas. Fleas identified on pets can carry flea-borne typhus. Therefore, pets must be treated with flea control treatments at regular intervals. 

• Fleas that spread flea-borne typhus can infect both cats and dogs.
• Fleas are usually active throughout the year.
• Flea management is the most effective strategy to avoid exposure to flea-borne typhus.

Even indoor animals can get flea-infested. Inspect pets and pet bedding for fleas regularly. The sight of flea excrement in your pet’s fur, known as flea dirt, may be the first indication of a flea infestation. Pet owners should maintain their pets on a flea and heartworm prevention regimen.

• Fleas can infest pets and backyard animals, causing flea-borne typhus to spread to people.
• Fleas cannot live in the absence of a host animal.
• Flea treatment should be administered to pets throughout the year.

Yards and residences should be maintained clean and in good shape to discourage animals from entering and dwelling. Check for any cracks or nesting spots where animals can enter and dwell. Lawns should be trimmed, and garbage or other objects must be removed. 

Feral cats, opossums, and other animals may be drawn to trash cans and other food sources. Therefore, never leave pet food out overnight. Regular use of flea control solutions on animals, including stray or neighborhood cats, can help avoid flea infestations.