Diagrams from the Los Angeles County Department of Public Health brochure entitled “Answers to Your Questions About Endemic Typhus Fever
Not many people in Los Angeles County get endemic typhus fever, but those who do contract it experience a sickness that makes them wish they would have followed some simple precautions. According to the Los Angles County Department of Health, the symptoms, which begin six to 14 days after exposure, include severe fever, headache, body chills, and aches and pains throughout the body. Some victims also develop rashes on various parts of their body. Endemic typhus is also called murine typhus, fleaborne typhus, and shop fever.
Because the disease has symptoms similar to other illnesses, it can be incorrectly diagnosed unless a specific blood test is performed. Currently, there are antibiotics that effectively kill the bacteria that cause the disease.
Angelo Bellomo, director of environmental health for the county health department, explained that endemic typhus is caused by two different types of bacteria: Rickettsia felis and Rickettsia typhi. “Rats, opossums, and cats are infected with the bacteria by fleas,” he said. “When a human comes in contact with an infected flea, the bacteria infect the human’s blood, causing the disease.”
Bellomo noted that the bacteria do not enter the blood stream directly from the flea bite, but rather from the feces excreted by the fleas while they are biting. “Fleas are not very clean insects,” he said. “The fact that you are bitten by a flea makes it almost certain that you have also been exposed to flea feces.” He explained that the typhus-causing bacteria are present in the feces and can enter the bloodstream when the feces comes in contact with the flea bite or any other wound or opening in the skin.
“Less than two percent of people who have untreated endemic typhus will die,” Bellomo said. He added that many of those who die from the disease have an already compromised immune system, or other serious health problems.
According to Bellomo, 37 people living in the areas covered by the county health department contracted endemic typhus in 2011. “That does not include the jurisdictions of Long Beach and Pasadena, because they have their own health departments,” he said.
John Holguin, epidemiologist for the Long Beach Health Department, said that only five people in Long Beach contracted the disease in 2011. Figures for state or national occurrences of the disease are not readily available, according to Bellomo.
Bellomo said that one person living in the 3300 block of Cerritos Avenue contracted the disease last September. As a result, county health department staff recently distributed fliers describing the disease and preventative measures to residents in the vicinity of the occurrence, and extending for several blocks in every direction. “We think it is prudent to distribute information to educate people in the area,” Bellomo said. “We also conducted an environmental assessment to see whether there are conditions that are conducive to the spread of the disease in that area, and our staff did not note any.”
He stressed that a person cannot contract the disease by coming into contact with a person who has it; only fleas transmit the bacteria. He added that in Los Angeles County, rats, opossums and cats carry the fleas that transmit the disease. People contract the disease because those animals are often in close proximity to humans.
Infected fleas can pass the bacteria to their offspring for up to 17 generations, but infected animals usually show no symptoms of the disease. Animals that carry the disease live in urban, suburban and rural areas. In Los Angeles County, almost all cases of endemic typhus fever can be traced to fleas from cats and opossums.
According to Bellomo, no vaccine exists that can immunize a person from endemic typhus, but simple precautionary measures can greatly reduce one’s chances of contracting the disease. Flea control tops the list of those measures. The county health department encourages residents to always keep their pets, yards and homes free of fleas. Pet owners should talk to a veterinarian about the best way to keep fleas off their pet, and they should not allow their animals to roam outdoors. Also homeowners should use insecticides that specifically target fleas to clear their yards and homes of the pest.
“Another preventative measure is to eliminate all harborage that can be used by opossums and rats on your property,” Bellomo said. “That means having screens over windows and crawl spaces, and keeping your yard clear of heavy undergrowth and debris where the animals can hide.”
Bellomo also warned against encouraging wild animals, feral cats and stray cats to visit your yard by directly or indirectly feeding them. He noted that indirect feeding usually happens by leaving the lids open on garbage cans or allowing pet food to stay in a bowl outdoors overnight. “Animals also eat fruit that falls from trees and vegetables from gardens,” he said. “It’s best to harvest fruits and vegetables as soon as they are ripe so that they do not attract animals to your yard.”
According to health department literature, people also need to take precautions when cleaning out an area that may have been used as a nest by rats, opossums or cats. The area should be sprayed with a disinfectant, by a person wearing protective equipment such as a particle mask or respirator, goggles and gloves. Taking these precautions also reduces exposure to rodent excretions that can cause other diseases.
“There are antibiotics that cure people of murine typhus, but as a public health agency, we focus primarily on prevention,” Bellomo stressed. “Our emphasis is on education and control, because it is always better to avoid acquiring a disease than to be treated for it after you have it.”