What is Typhus?
Typhus is a disease caused by infection with one or more rickettsial bacteria which are being transmitted when a person is bitten by mites, fleas, ticks, or lice.
Fleas, mites, lice, and ticks all belong to the arthropod invertebrate family. When arthropods carrying rickettsial bacteria bite someone, they transmit the bacteria that causes typhus. When a person scratches the bite, it further opens the skin and allows the bacteria to gain access to the bloodstream. Once in the bloodstream, the bacteria continue to grow and multiply.
Types of Typhus
There are three different types of typhus:
- epidemic (louse-borne) typhus
- endemic (murine) typhus
- scrub typhus
Typhus outbreaks are mostly predominant regions with poor sanitation, poverty, close human contact, and in developing countries. Typhus is generally not a problem in the United States, but California is currently recording an increase in typhus outbreak.
If left untreated typhus can lead to severe complications. Consult your doctor immediately if you suspect that you may have typhus.
Cause of Typhus
Unlike a cold or flu, typhus is not transmitted from person to person. There are three different types of typhus, and each type is caused by a different type of bacterium and transmitted by a different type of arthropod.
This type is carried by the body louse, and all ticks. It is caused by Rickettsia prowazekii, and can be found around the world. However, is typically found in areas of high population and poor sanitation, where conditions promote lice infestation.
This is also called murine typhus. It is caused by Rickettsia typhi and is carried by the rat flea or cat flea. Endemic typhus can be found globally. It may be found among people in close contact with rats. It’s not common in the United States, but cases have been reported in some areas, primarily Texas and southern California.
This type is caused by Orientia tsutsugamushi and carried by mites in their larval stage when they are chiggers. This type of typhus is more commonly found in Asia, Australia, Papua New Guinea, and the Pacific Islands. It’s also called tsutsugamushi disease.
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The louse, flea, tick, or mite becomes a carrier of the bacteria when they feed on the blood of an infected person or an infected rodent.
A person can become infected by sleeping on bed sheets infested with lice. In addition to being transmitted through your skin by their bites, can also be transmitted through their feces. If you scratch the skin over an area where lice or mites have been feeding, the bacteria in their feces can enter your bloodstream through the tiny wounds on your skin.
Symptoms of Typhus
Symptoms vary slightly by the type of typhus, but there are symptoms that are associated with all three types of typhus, such as:
Symptoms of epidemic typhus usually appear unexpectedly. They may include:
- high fever (above 102.2°F)
- severe headache
- rash that begins on the back or chest and spreads
- stupor and seeming out of touch with reality
- low blood pressure(hypotension)
- eye sensitivity to bright lights
- severe muscle pain
The symptoms of endemic typhus last for 10 to 12 days and are very similar to the symptoms of epidemic typhus but are less severe. They include:
- dry cough
- nausea and vomiting
Symptoms seen in people with scrub typhus include:
The incubation period for the disease is five to 14 days, on average. This means that symptoms won’t usually appear for up to five to 14 days after you are bitten.
Your doctor will ask about your symptoms and your medical history. To help with the diagnosis, inform your doctor if you:
- have traveled abroad recently
- are living in a crowded environment
- know of a typhus outbreak in your community
Diagnosis is difficult because symptoms are common to other infectious diseases, including:
- malaria, infectious disease spread by mosquitos
- brucellosis, an infectious disease caused by Brucellabacteria
The doctor may order some tests to further help with diagnosis. These may include:
- Western blot: test to identify the presence of typhus
- skin biopsy: a sample of the skin from the bite site will be tested in a lab
- immunofluorescence test: uses fluorescent dyes to detect typhus antigen in samples of serum taken from the bloodstream.
Complications of Typhus
If left untreated, typhus could lead to:
- hypovolemia: This is a decrease in blood volume
- hepatitis: Inflammation of the liver
- gastrointestinal hemorrhage: Bleeding inside the intestines
Treatment for Typhus
Antibiotics most commonly used to treat typhus include:
- doxycycline(Doryx, Vibramycin): the preferred treatment
- chloramphenicol: an option for those not pregnant or breastfeeding
- ciprofloxacin (Cipro): used for adults who are unable to take doxycycline
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