BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuTyphusMurine typhus; Epidemic typhus; Endemic typhus; Brill-Zinsser disease; Jail feverTyphus is a bacterial disease spread by lice or fleas. Causes Typhus is caused by two types of bacteria: Rickettsia typhi or Rickettsia prowazekii.Rickettsia typhi causes endemic or murine typhus.Endemic typhus is uncommon in the United States. It is usually seen in areas where hygiene is poor, and the temperature is cold. Endemic typhus is sometimes called "jail fever." The bacteria that cause this type of typhus is usually spread from rats to fleas to humans. Murine typhus occurs in the southern United States, particularly California and Texas. It is often seen during the summer and fall. It is rarely deadly. You are more likely to get this type of typhus if you are around rat feces or fleas, and other animals such as cats, possums, raccoons, and skunks. Rickettsia prowazekii causes epidemic typhus. It is spread by lice.Brill-Zinsser disease is a mild form of epidemic typhus. It occurs when the bacteria become active again in a person who was previously infected. It is more common in older adults. Symptoms Symptoms of murine or endemic typhus may include:Abdominal pain Backache Dull red rash that begins on the middle of the body and spreads Fever, can be extremely high, 105°F to 106°F (40.6°C to 41.1°C) and can last up to 2 weeks Hacking, dry cough Headache Joint and muscle pain Nausea and vomitingSymptoms of epidemic typhus may include:High fever, chills Confusion, decreased alertness, delirium DeliriumDelirium is sudden severe confusion due to rapid changes in brain function that occur with physical or mental illness.ImageRead Article Now Book Mark Article Cough Severe muscle and joint pain Lights that appear very bright; light may hurt the eyes Low blood pressure Rash that begins on the chest and spreads to the rest of the body (except the palms of the hands and soles of the feet) Severe headacheThe early rash is a light rose color and fades when you press on it. Later, the rash becomes dull and red and does not fade. People with severe typhus may also develop small areas of bleeding into the skin. Exams and Tests Diagnosis is often based on a physical examination and detailed information about the symptoms. You may be asked if you recall being bit by fleas. If the health care provider suspects typhus, you will be started on medicines right away. Blood tests will be ordered to confirm the diagnosis. Treatment Treatment includes the following antibiotics:Doxycycline Tetracycline Chloramphenicol (less common) Tetracycline taken by mouth can permanently stain teeth that are still forming. It is usually not prescribed for children until after all of their permanent teeth have grown.People with epidemic typhus may need oxygen and intravenous (IV) fluids.IntravenousIntravenous means "within a vein. " Most often it refers to giving medicines or fluids through a needle or tube inserted into a vein. This allows th...Read Article Now Book Mark Article Outlook (Prognosis) People with epidemic typhus who receive treatment quickly should completely recover. Without treatment, death can occur, with those over age 60 having the highest risk of death.Only a small number of untreated people with murine typhus may die. Prompt antibiotic treatment will cure nearly all people with murine typhus. Possible Complications Typhus may cause these complications: Renal insufficiency (kidneys cannot function normally) Renal insufficiencyAcute kidney failure is the rapid (less than 2 days) loss of your kidneys' ability to remove waste and help balance fluids and electrolytes in your b...ImageRead Article Now Book Mark Article Pneumonia PneumoniaPneumonia is a breathing (respiratory) condition in which there is an infection of the lung. This article covers community-acquired pneumonia (CAP). ...ImageRead Article Now Book Mark Article Central nervous system damage Central nervous systemThe central nervous system is composed of the brain and spinal cord. Your brain and spinal cord serve as the main "processing center" for your entir...ImageRead Article Now Book Mark Article When to Contact a Medical Professional Call your provider if you develop symptoms of typhus. This serious disorder can require emergency care. Prevention Avoid being in areas where you might encounter rat fleas or lice. Good sanitation and public health measures reduce the rat population.LiceBody lice are tiny insects (scientific name is Pediculus humanus corporis) that are spread through close contact with other people. Two other types o...ImageRead Article Now Book Mark Article Measures to get rid of lice when an infection has been found include:Bathing Boiling clothes or avoiding infested clothing for at least 5 days (lice will die without feeding on blood) Using insecticides (10% DDT, 1% malathion, or 1% permethrin)Open ReferencesReferencesBlanton LS, Dumler JS, Walker DH. Rickettsia typhi (murine typhus). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 190.Blanton LS, Walker DH. Rickettsia prowazekii (epidemic or louse-borne typhus). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 189.Fournier PE, Raoult D. Rickettsial infections. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 311.AllVideoImagesTogBody louse, female and larvae - illustration This is a magnified view of a female body louse with larvae. Lice cause itching and a characteristic excoriated skin rash (looks like a scrape). They may also transmit diseases, including relapsing fever, typhus, and trench fever. (Image courtesy of the Centers for Disease Control and Prevention.)Body louse, female and larvaeillustrationFlea - illustration Different types of fleas prefer specific animals as hosts, but will infest humans if their specific hosts are unavailable. Fleas can carry plague and typhus. They are also thought to transmit several other diseases. (Image courtesy of the Centers for Disease Control and Prevention.) FleaillustrationBody louse, female and larvae - illustration This is a magnified view of a female body louse with larvae. Lice cause itching and a characteristic excoriated skin rash (looks like a scrape). They may also transmit diseases, including relapsing fever, typhus, and trench fever. (Image courtesy of the Centers for Disease Control and Prevention.)Body louse, female and larvaeillustrationFlea - illustration Different types of fleas prefer specific animals as hosts, but will infest humans if their specific hosts are unavailable. Fleas can carry plague and typhus. They are also thought to transmit several other diseases. (Image courtesy of the Centers for Disease Control and Prevention.) FleaillustrationRelated Information Fever(Symptoms)Rashes(Symptoms)Q fever(Condition)Acute kidney failure(Condition)Community-acquired pneumonia in adults(Condition)Central nervous system(Special Topic)Pneumonia(In-Depth) Review Date: 12/24/2020 Reviewed By: Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- © 1997- All rights reserved. A.D.A.M. content is best viewed in IE9 or above, Firefox and Google Chrome browser.Content is best viewed in IE9 or above, Firefox and Google Chrome browser.