The bacterial disease isn't unheard of in the area, but experts aren't sure what's causing a recent spike in diagnoses.

By Sarah Klein
October 09, 2018

Public officials are warning of an outbreak of typhus, a bacterial disease usually spread by lice or fleas, in the Los Angeles area.

Cases of the flea-borne form of the disease—called endemic or murine typhus—are seen in the area every year, according to the Los Angeles County Department of Public Health. But in recent years, the number of typhus cases has doubled to almost 60 annually. Most alarming of all? Some unusual clusters of the disease, including nine cases in downtown Los Angeles and 20 in Pasadena—“well above the expected one to five cases per year,” in Pasadena, according to the city.

Flea-borne typhus is, as the name implies, carried by fleas. Those fleas typically hitch a ride on rats, stray cats, and possums in the L.A. area, according to the county—not exactly the kind of animals California residents would presumably be cuddling up with. But outdoor pets may come in contact with these animals and bring infected fleas home. (Animals themselves don’t actually get sick from typhus.)

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It’s actually the poop of those infected fleas that causes the biggest problem to humans. The typhus-causing bacteria, Rickettsia typhi, lingers there. (Another bacterium, Rickettsia prowazekii, causes what’s called epidemic typhus, which is spread by lice.) “People get sick with murine typhus when infected flea feces are rubbed into cuts or scrapes in the skin,” according to the Centers for Disease Control and Prevention (CDC). Within two weeks after this exposure, typhus symptoms appear. People might develop fevers and chills, body aches, nausea, vomiting, or a rash, which usually occurs around the fifth day of being sick.

Luckily, most people recover from endemic typhus just fine. When cases need to be treated, it's usually with the antibiotic doxycycline. Severe cases can lead to liver, kidney, heart, lung, or brain damage, according to the CDC.

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There’s no vaccine to protect against typhus (you might be confusing it with typhoid, a more serious disease travelers can pick up from contaminated food or water). But you can take some small steps to stay safe. The L.A. County Department of Health is advising residents to use flea-control products on pets and keep them indoors if possible. It’s also smart for outdoorsy types in the area to use insect repellent labeled for protection against fleas.

It probably goes without saying, but if you're worried about typhus, stay away from wild or stray animals that might carry fleas. Don’t encourage them to come closer to your home, either. That means don't leave tempting pet food outside, keep outdoor trash containers covered tightly, and close up or clean any areas where stray animals might find shelter around your home. (Wear gloves and a mask while you’re doing that work, too!)

Endemic typhus doesn’t spread from person to person (phew!), and it’s most commonly found in the southern U.S., particularly California and Texas, during the summer and fall.

Authorities are still investigating what may have led to the recent rise in typhus cases in California, but it does seem to be part of a larger trend of concern. Earlier this year, the CDC reported that the number of cases of diseases spread by ticks, fleas, and mosquitoes has more than tripled from 2004 to 2016. Still, typhus remains rare, and fleas are more likely to carry the bacteria which causes the plague.

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