Table of ContentsView AllTable of ContentsTypesSymptomsDiagnosisTreatmentLong-Term EffectsPrevention
Table of ContentsView All
View All
Table of Contents
Types
Symptoms
Diagnosis
Treatment
Long-Term Effects
Prevention
The infection can spread through the entire bloodstream with systemic (whole-body) involvement, including affecting the central nervous system.
Although the disease is more common in underdeveloped areas, it can be found all over the world.It’s uncommon in the United States, but there have been documented cases in parts of the US, including California.
Typhus is considered one of the oldest recorded diseases and was found to have plagued certain populations as far back as the 18th century.
Pierre Aden/Eye Em
The three different types of typhus include:
Types of Typhus
Since typhus presents itself differently depending on the cause and type of the infection, let’s take a more in-depth look at the different strains of the bacterial disease and what each does to the human body.
Murine Typhus (Endemic)
Found mostly in tropical and subtropical climates, endemic typhus is spread through fleas found on rodents. The specific bacteria responsible for the infection is calledRickettsia typhi. The bacteria depend entirely on rodents for its complete lifecycle and thus rely heavily on those populations to thrive.
The bacteria live in the gut of the flea and are excreted in flea feces. When the living bacteria in the feces manage to enter the bloodstream of a mammal, infection occurs.
Louse Typhus (Epidemic)
Epidemic typhus is spread through infected body lice populations and can be found worldwide, although it is more common in Asia, parts of Africa, and Mexico.The number of cases is higher in areas where sanitation is low and population numbers are high.
The specific bacteria that causes this type of typhus is called theRickettsia prowazekii. It is generally transmitted to lice when they feed on infected hosts.
Cases in the US have been attributed to infected flying squirrel populations. The bacteria survive in the feces of lice and are spread when fecal matter enters the human bloodstream. But it can also be spread via inhalation.
Scrub Typhus (Bush Typhus)
Scrub typhus can be contracted through both direct feeding and through the fecal intrusion into the bloodstream. Also known as tsutsugamushi disease, this infection can be severe and potentially fatal.
This photo contains content that some people may find graphic or disturbing.See PhotoReproduced with permission from ©DermNet New Zealandwww.dermnetnz.org2023.
This photo contains content that some people may find graphic or disturbing.See Photo
This photo contains content that some people may find graphic or disturbing.
Reproduced with permission from ©DermNet New Zealandwww.dermnetnz.org2023.
Typhus Symptoms
Scrub Typhus
Symptoms of scrub typhus include:
In more severe cases of scrub typhus, neurological symptoms can appear and include:
Louse Typhus
Symptoms of louse typhus include:
More serious symptoms can occur in severe cases of the infection including:
The mortality (death) rate for those infected with louse typhus can be as high as 60% when the infection isn’t treated and as low as 5% when it’s treated with antibiotics.
Murine Typhus
Murine typhus symptoms are usually mild, and some people who contract the illness can recover without any treatment at all.
Symptoms include:
In very rare cases, when the bacteria invade organs such as the heart, brain, kidney, liver, or lungs, it can leave lasting damage. The infection has been known to lead toacute respiratory distress syndrome, a serious lung condition that can lead to oxygen deficiency, and possibly death.
Other severe complications that can occur in a case of murine typhus include:
The chances that you would contract typhus are quite low, especially if you haven’t recently spent time in a high-risk area. If you have symptoms and have had possible exposure to the bacteria, you may need diagnostic testing.
Tests you might need include:
All forms of typhus are treated with antibiotics. For those who get prompt treatment, typhus is generally resolved.
Antibiotics used to treat bacterial infection include:
These antibiotics are used to rid the body of bacteria.
Long-Term Effects of Typhus
When typhus remains untreated, it can lead to long-term health effects. Serious and lasting symptoms that can occur in an untreated typhus infection include:
Low blood pressure, pneumonia, organ failure, and gangrene are serious complications that can lead to death from typhus.
The most important step to avoiding a typhus infection is staying away from rodents and wild animals, even the adorable cuddly ones.
If you have pets, be sure to keep them away from any other rodents or animals that may spread fleas or mites (no matter how hard they may want to chase that squirrel).
A Word From Verywell
Typhus can make you very sick if you catch the infection. Try to avoid exposure in your day to day life and be sure to practice prevention if you travel to an area of high risk. If you are exposed, be watchful of symptoms and see your healthcare provider promptly if you begin to experience the effects of the infection—treatment can be lifesaving.
15 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Sekeyová Z, Danchenko M, Filipčík P, Fournier PE.Rickettsial infections of the central nervous system.PLoS Negl Trop Dis. 2019;13(8):e0007469. doi:10.1371/JOURNAL.PNTD.0007469World Health Organization.Typhoid.Cedars-Sinai.Typhus: What you need to know.Centers for Disease Control and Prevention.Murine typhus.New Jersey Department of Agriculture.Typhus fever—Rickettsia prowazekii.Centers for Disease Control and Prevention.Epidemic typhus.Centers for Disease Control and Prevention.Scrub typhus.Mahajan SK, Mahajan SK.Neuropsychiatric manifestations of scrub typhus.J Neurosci Rural Pract. 2017;8(3):421-426. doi:10.4103/jnrp.jnrp_44_17Virginia Department of Health.Epidemic typhus fever (louse-borne).Osterloh A, Papp S, Moderzynski K, Kuehl S, Richardt U, Fleischer B.PersistingRickettsia typhicauses fatal central nervous system inflammation.Infect Immun. 2016;84(5):1615-1632. doi:10.1128/IAI.00034-16The Center for Food Security and Public Health.Typhus fever.van der Vaart TW, van Thiel P, Juffermans NP, et al.Severe murine typhus with pulmonary system involvement.Emerging Infectious Diseases. 2014;20(8):1375-1377. doi:10.3201/eid2008.131421Afzal Z, Kallumadanda S, Wang F, Hemmige V, Musher D.Acute febrile illness and complications due to Murine typhus, Texas, USA.Emerg Infect Dis. 2017;23(8):1268-1273.Centers for Disease Control and Prevention.Clinical overview of murine typhus.Faucher J-F, Socolovschi C, Aubry C, et al.Brill-Zinsser disease in Moroccan man, France, 2011.Emerg Infect Dis. 2012;18(1):171-172. doi:10.3201/eid1801.111057
15 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Sekeyová Z, Danchenko M, Filipčík P, Fournier PE.Rickettsial infections of the central nervous system.PLoS Negl Trop Dis. 2019;13(8):e0007469. doi:10.1371/JOURNAL.PNTD.0007469World Health Organization.Typhoid.Cedars-Sinai.Typhus: What you need to know.Centers for Disease Control and Prevention.Murine typhus.New Jersey Department of Agriculture.Typhus fever—Rickettsia prowazekii.Centers for Disease Control and Prevention.Epidemic typhus.Centers for Disease Control and Prevention.Scrub typhus.Mahajan SK, Mahajan SK.Neuropsychiatric manifestations of scrub typhus.J Neurosci Rural Pract. 2017;8(3):421-426. doi:10.4103/jnrp.jnrp_44_17Virginia Department of Health.Epidemic typhus fever (louse-borne).Osterloh A, Papp S, Moderzynski K, Kuehl S, Richardt U, Fleischer B.PersistingRickettsia typhicauses fatal central nervous system inflammation.Infect Immun. 2016;84(5):1615-1632. doi:10.1128/IAI.00034-16The Center for Food Security and Public Health.Typhus fever.van der Vaart TW, van Thiel P, Juffermans NP, et al.Severe murine typhus with pulmonary system involvement.Emerging Infectious Diseases. 2014;20(8):1375-1377. doi:10.3201/eid2008.131421Afzal Z, Kallumadanda S, Wang F, Hemmige V, Musher D.Acute febrile illness and complications due to Murine typhus, Texas, USA.Emerg Infect Dis. 2017;23(8):1268-1273.Centers for Disease Control and Prevention.Clinical overview of murine typhus.Faucher J-F, Socolovschi C, Aubry C, et al.Brill-Zinsser disease in Moroccan man, France, 2011.Emerg Infect Dis. 2012;18(1):171-172. doi:10.3201/eid1801.111057
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Sekeyová Z, Danchenko M, Filipčík P, Fournier PE.Rickettsial infections of the central nervous system.PLoS Negl Trop Dis. 2019;13(8):e0007469. doi:10.1371/JOURNAL.PNTD.0007469World Health Organization.Typhoid.Cedars-Sinai.Typhus: What you need to know.Centers for Disease Control and Prevention.Murine typhus.New Jersey Department of Agriculture.Typhus fever—Rickettsia prowazekii.Centers for Disease Control and Prevention.Epidemic typhus.Centers for Disease Control and Prevention.Scrub typhus.Mahajan SK, Mahajan SK.Neuropsychiatric manifestations of scrub typhus.J Neurosci Rural Pract. 2017;8(3):421-426. doi:10.4103/jnrp.jnrp_44_17Virginia Department of Health.Epidemic typhus fever (louse-borne).Osterloh A, Papp S, Moderzynski K, Kuehl S, Richardt U, Fleischer B.PersistingRickettsia typhicauses fatal central nervous system inflammation.Infect Immun. 2016;84(5):1615-1632. doi:10.1128/IAI.00034-16The Center for Food Security and Public Health.Typhus fever.van der Vaart TW, van Thiel P, Juffermans NP, et al.Severe murine typhus with pulmonary system involvement.Emerging Infectious Diseases. 2014;20(8):1375-1377. doi:10.3201/eid2008.131421Afzal Z, Kallumadanda S, Wang F, Hemmige V, Musher D.Acute febrile illness and complications due to Murine typhus, Texas, USA.Emerg Infect Dis. 2017;23(8):1268-1273.Centers for Disease Control and Prevention.Clinical overview of murine typhus.Faucher J-F, Socolovschi C, Aubry C, et al.Brill-Zinsser disease in Moroccan man, France, 2011.Emerg Infect Dis. 2012;18(1):171-172. doi:10.3201/eid1801.111057
Sekeyová Z, Danchenko M, Filipčík P, Fournier PE.Rickettsial infections of the central nervous system.PLoS Negl Trop Dis. 2019;13(8):e0007469. doi:10.1371/JOURNAL.PNTD.0007469
World Health Organization.Typhoid.
Cedars-Sinai.Typhus: What you need to know.
Centers for Disease Control and Prevention.Murine typhus.
New Jersey Department of Agriculture.Typhus fever—Rickettsia prowazekii.
Centers for Disease Control and Prevention.Epidemic typhus.
Centers for Disease Control and Prevention.Scrub typhus.
Mahajan SK, Mahajan SK.Neuropsychiatric manifestations of scrub typhus.J Neurosci Rural Pract. 2017;8(3):421-426. doi:10.4103/jnrp.jnrp_44_17
Virginia Department of Health.Epidemic typhus fever (louse-borne).
Osterloh A, Papp S, Moderzynski K, Kuehl S, Richardt U, Fleischer B.PersistingRickettsia typhicauses fatal central nervous system inflammation.Infect Immun. 2016;84(5):1615-1632. doi:10.1128/IAI.00034-16
The Center for Food Security and Public Health.Typhus fever.
van der Vaart TW, van Thiel P, Juffermans NP, et al.Severe murine typhus with pulmonary system involvement.Emerging Infectious Diseases. 2014;20(8):1375-1377. doi:10.3201/eid2008.131421
Afzal Z, Kallumadanda S, Wang F, Hemmige V, Musher D.Acute febrile illness and complications due to Murine typhus, Texas, USA.Emerg Infect Dis. 2017;23(8):1268-1273.
Centers for Disease Control and Prevention.Clinical overview of murine typhus.
Faucher J-F, Socolovschi C, Aubry C, et al.Brill-Zinsser disease in Moroccan man, France, 2011.Emerg Infect Dis. 2012;18(1):171-172. doi:10.3201/eid1801.111057
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