Texas Sees Rise in Flea-Borne Typhus Cases

Flea-borne typhus, otherwise known as murine or endemic typhus, is on the rise in Texas. Here’s what you need to know.

Texas is currently experiencing an alarming increase of flea-borne typhus cases. As Texas Public Radio reported, the state has more reports of the illness (also referred to as murine typhus or endemic typhus) than any other state in the US. Upwards of 6,700 cases were previously reported between 2008 and 2023, with approximately 70% of patients requiring hospitalization. In some instances, when typhus is left untreated, it can be fatal—in Texas’s case, 14 deaths were attributed to the disease between that 2008-2023 timespan. 

As of writing, there have been 682 reported provisional cases, but the Texas State Health Services indicate this may rise, as the illness usually peaks between late summer and fall. Over the last few years, areas like Houston, Dallas-Forth Worth, Austin, and San Antonio have been the primary hotbeds for typhus in the state.

The disease is spread by fleas, and while the sickness was mostly eliminated in the US, it’s making a steady comeback, likely due to climate change. TPR noted that fleas typically thrive in warmer weather, as that allows them to reproduce more quickly, which rapidly multiplies typhus bacteria production. This leads to a greater chance of transmission.

Typhus is usually spread to humans from animals including cats, dogs, and opossums, to name a few. These animals can get fleas, and they also act as a host for certain diseases, like typhus. People who spend a lot of time outdoors, or who often come into contact with these animals (more specifically, opossums, free-roaming cats, and rats) are at an increased risk of infection.

Below, we’ll go over some of the most common symptoms and treatment options, and we’ll also discuss how you can prevent infections from occurring to begin with. 

Common symptoms of flea-borne typhus 

According to the CDC, flea-borne typhus symptoms appear between three and 14 days after contact with infected fleas. Common signs of infection in humans include:

  • Fever and chills
  • Body aches, headache, and muscle pain
  • Stomach pain, loss of appetite, nausea, vomiting
  • Cough
  • Rash (this occurs in roughly half of all patients, and usually starts about five days into the illness)

Extreme sickness can occur, but most cases are completely resolved with the help of antibiotics. Deaths occur in approximately 1% of all flea-borne typhus cases. However, if left untreated, or if it’s not treated quickly, it can lead to hospitalization or severe side effects, like organ damage.

If you believe you may have typhus, contact a health professional right away to get tested. It’s important to notify them of any contact you may have had with wildlife, stray animals, or domestic rodents.

Testing and treatment 

Depending on your healthcare provider, you may be required to undergo a blood test to look for murine typhus exposure. If this is the case, your doctor will likely start treatment right away while awaiting test results, as it can sometimes take a few weeks for laboratory results to come in. 

The infection is treated with an antibiotic called doxycycline, which is suitable for individuals of all ages. When used right away, it helps lead to a swift recovery. If it’s not treated properly with doxycycline, typhus can take anywhere between two to three weeks to clear up on its own and may lead to worsening symptoms during that time. 

How to prevent infection 

Reducing your exposure to fleas is the most important thing in terms of preventing infection. If you have a pet that’s allowed outdoors, set up an appointment with your veterinarian to go over flea control options, like topical flea prevention products, flea collars, and oral medication, to see what would be best. NOTE: Permethrin, a type of flea prevention medication, shouldn’t be used on cats, though.

Taking additional preventative measures to keep wild animals and rodents away from your house is equally important. Always store your food in sealed containers, keep the lids on your trash cans closed tightly, and remove any clutter from around the outside of your house (like brush, leaves, and rock). 

Refrain from petting or feeding stray or wild animals—if you do, remember to always wear gloves, and to use an insect repellent when you’re spending time outdoors.


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