Flea-borne Typhus Health Alert

The Texas Department of State Health Services (DSHS) issued a health alert due to an increase in reports of flea-borne typhus in 2017. According to the alert, “DSHS is requesting that healthcare providers increase their clinical suspicion for patients presenting with fever and one or more of the following: headache, myalgia, anorexia, rash, nausea/vomiting, thrombocytopenia, or any hepatic transaminase elevation. The diagnosis of flea-borne typhus relies on a high index of clinical suspicion and on results of specific laboratory tests.

People with typhus report non-specific symptoms including fever, headache, chills, malaise, anorexia, myalgia, rash, nausea, and vomiting. Laboratory findings may include thrombocytopenia, hyponatremia, elevated hepatic transaminases, and CSF abnormalities consistent with aseptic meningitis. Although flea-borne typhus is often a mild, self-limited illness, more than 60% of reported cases are hospitalized. Since 2003, eight deaths have been attributed to flea-borne typhus infection in Texas. When left untreated, severe illness can cause damage to one or more organs, including the liver, kidneys, heart, lungs, and brain. As with other rickettsial infections, prompt antibiotic treatment is recommended; treatment should not be delayed pending diagnostic tests. Additional clinician guidance on typhus can be accessed at the CDC website: https://www.cdc.gov/typhus/murine/index.html.”

Additionally, “Flea-borne typhus cases are required to be reported to the local health department (LHD) within one week. If there is no LHD, reports can be made to the Regional DSHS Zoonosis Control Office. Contact information for Regional Zoonosis Control staff is available at: http://www.dshs.texas.gov/idcu/health/zoonosis/contact/”. View the full health alert here.