Health Alert: Flea-borne Typhus Activity on the Rise in Tarrant County

Tarrant County Public Health (TCPH) has issued a health alert to area health care providers in response to a rise in local flea-borne typhus cases. It asks them to consider a diagnosis for people with fever and at least one other symptom of the disease.

TCPH has reported 22 cases so far this year, compared to six cases in 2016, four in 2015 and three in 2014. Cook Children's has seen eight cases this year.

The Texas Department of State Health Services says it has seen more than 400 cases, the most in 16 years.

Typhus can occur in any age group, but more than 25 percent of the cases are reported among those between the ages of 6-15 years of age.

Flea-borne typhus is caused by an infection with the bacterium Rickettsia typhi. Rat and cat fleas are the primary carriers, but other animals such as dogs and possums can carry the infection.

Transmission to humans can occur when infected flea feces are scratched into a bite site or another abrasion to the skin, or rubbed into to the mucous membrane that covers the front of the eyes and lines the inside of the eyelids (conjunctiva).

Mary Suzanne Whitworth, M.D., medical director of Infectious Diseases, says she’s seen a rise in the number of children treated for flea-borne typhus, but she’s not sure why it has been diagnosed more recently. She theorizes it could be because doctors are more aware of the condition. 

Early symptoms of flea-borne typhus develop within 14 days of contact with infected fleas and include headache, fever, nausea and body aches. Five or six days after the initial symptoms, a rash that starts on the trunk of the body and spreads to the arms and legs may occur. Other causes may be warmer weather, the amount of rain lately or more people owning pets.

Dr. Whitworth said most people are treated on an outpatient basis, but some have required hospitalization at Cook Children’s. Flea-borne typhus is treated with antibiotics and people will not get the condition again after they recover

“This isn’t something new,” Dr. Whitworth said. “Endemic typhus has been around for a very long time. Many people get over typhus without treatment, but you should see a doctor if you have fever and at least one other symptom of the disease, such as a rash or headache.”

The best precautions to guard against contracting flea-borne typhus are:

• Keep yards clean so that rodents, opossums and stray cats cannot live there by removing any brush or trash, keeping the grass mowed and keeping firewood off the ground.
• Do not leave pet food out at night as this attracts other animals.
• Prevent rodents from living in houses.
• Treat for fleas with a commercial flea control product before beginning rodent control in houses or yards. Fleas will search for new hosts when rodents die.
• Control the fleas on pets regularly. Ask a veterinarian about flea control products that are safe to use on pets.
• Wear gloves and insect repellent when handling sick or dead animals.
• Use insect repellant when hunting, camping or engaging in any other outdoor activities.

- Content Provided by Texas Health and Human Services and Tarrant County Public Health.