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Eight cases of confirmed typhus in Long Beach, California

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Senior Moderator
http://hisz.rsoe.hu/alertmap/woalert_read.php?glide=EH-20091024-23596-USA&cat=dis&lang=eng

Eight people in Long Beach were recovering Saturday after being hospitalized with a rare form of typhus that's spread by fleas. Of the eight people who contracted the disease, five were male. Patients' ages ranged from less than 1 year old to 59 years old, said John Holquin, epidemiologist with the city's Department of Health. The last four cases were diagnosed in September, and the remaining four were diagnosed in July and August. Last year, two cases of flea-borne typhus were reported, but health department officials could not explain this year's increase. "This is a rare disease," said city Health Officer Dr. Helene Calvet, describing murine typhus. "The vast majority of the population is not going to come in contact with this disease or come down with it." The disease is treatable with antibiotics and most people recover. Murine typhus is spread by fleas that have hosted on infected cats, opossums, raccoons, rats and other rodents. Common symptoms include high fever, severe headaches, body aches and and rash. It can result in severe illness and hospitalization, but rarely causes death. it is not spread person-to-person. While biting people, the fleas expel their feces, which contain the bacteria that causes the disease. The fleas' excrement enters the body through the bite wound or from a person scratching the bite area. In 2007, nine cases were reported. Most flea-borne typhus cases occur in Southern California, south Texas and Hawaii, according to the health department Web site. Health officials say keeping pets' flea problems is the best strategy for preventing the spread of the disease. Pets may be exposed to fleas that may have been carried by possums or rodents
 
Re: Eight cases of confirmed typhus in Long Beach, California

http://www.promedmail.org/pls/otn/f..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,79802

Archive Number 20091025.3692
Published Date 25-OCT-2009
Subject PRO/AH/EDR> Murine typhus - USA (03): (CA)

MURINE TYPHUS - USA (03): (CALIFORNIA)
*************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Sat 24 Oct 2009
Source: KTLA [edited]
<http://www.ktla.com/news/landing/ktla-long-beach-typhus,0,3918630.story>


Eight people in Long Beach are recovering Saturday [24 Oct 2009]
after being hospitalized with a rare form of typhus that is spread by
fleas. Of the 8 people who contracted the disease, 5 were male.

Patients' ages ranged from less than one year old to 59 years old,
said John Holquin, epidemiologist with the city's Department of
Health. The last 4 cases were diagnosed in September 2009, and the
remaining 4 were diagnosed in July and August 2009. In 2008, 2 cases
of flea-borne [murine] typhus were reported, and health department
officials could not explain 2009's increase.

"This is a rare disease," said city Health Officer Dr. Helene Calvet,
describing murine typhus. "The vast majority of the population is not
going to come in contact with this disease or come down with it."

The disease is treatable with antibiotics, and most people recover.
Murine typhus is spread by fleas that have hosted on infected cats,
opossums, raccoons, rats and other rodents. Common symptoms include
high fever, severe headaches, body aches and rash. It can result in
severe illness and hospitalization, rarely causes death, and it is
not spread person-to-person.

While biting people, the fleas expel their feces, which contain the
bacteria that cause the disease. The fleas' excrement enters the body
through the bite wound or from a person scratching the bite area.

In 2007, 9 cases were reported. Most flea-borne typhus cases occur in
Southern California, south Texas and Hawaii, according to the health
department website.

--
Communicated by:
ProMED-mail Rapporteur Susan Baekeland

[The term typhus comes from the Greek, _typhein_ -- to smoke -- which
may refer to the smoky or clouded mental status that patients present with.

Murine typhus, caused by _Rickettsia typhi_, is distributed widely
throughout the world, especially in the warm and humid coastal
environments of tropic and subtropical climes. In the developed
world, the infection is found along the eastern coasts of the south
Atlantic states in the USA, the Caribbean, the Pacific coasts of the
southwestern USA, as well as Hawaii. In Europe, it is distributed
along the Mediterranean coast as well as the Atlantic and
Mediterranean coasts of Africa.

It is a zoonosis in which rats often function as the disease's
asymptomatic reservoir, and the Oriental rat flea _Xenopsylla
cheopis_ is the most common vector. Although generally coastal in
distribution, the disease may well spread away from the coast via
major routes of transportation. Although rickettsia-infected flea
feces being rubbed into a flea bite appear to be the major vehicle of
transmission to humans, flea bites themselves, and aerosolization of
flea feces, may transmit infection as well.

Murine typhus is a relatively mild disease as compared to epidemic
typhus. Among patients admitted to an acute care hospital with this
disease, only 10 percent require intensive care but one to 4 percent die.

Diagnosis is based on serology. However, identification of
rickettsiae in smear or culture of skin lesions may be performed by
specialized laboratories.

The typical adult therapy consists of doxycycline 100 mg twice a day
for 3-5 days. - Mod.LL]
 
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