title: Murine typhus: an unrecognized suburban vectorborne disease.
abstract: Murine typhus, an acute febrile illness caused by Rickettsia typhi, is distributed worldwide. Mainly transmitted by the fleas of rodents, it is associated with cities and ports where urban rats (Rattus rattus and Rattus norvegicus) are abundant. In the United States, cases are concentrated in suburban areas of Texas and California. Contrary to the classic rat-flea-rat cycle, the most important reservoirs of infection in these areas are opossums and cats. The cat flea, Ctenocephalides felis, has been identified as the principal vector. In Texas, murine typhus cases occur in spring and summer, whereas, in California, cases have been documented in summer and fall. Most patients present with fever, and many have rash and headache. Serologic testing with the indirect immunofluorescence assay is the preferred diagnostic method. Doxycycline is the antibiotic of choice and has been shown to shorten the course of illness.
authors.affiliation: Acute Communicable Disease Control Program, Los Angeles County Public Health Department, Los Angeles, California 90012, USA. rciven@ph.lacounty.gov
authors.forename: Rachel
authors.initials: R
authors.lastname: Civen
authors.forename: Van
authors.initials: V
authors.lastname: Ngo
mesh_terms: D000818:Animals; D000829:Animals, Domestic / Q000469:parasitology; D002140:California / Q000453:epidemiology; D002371:Cat Diseases / Q000453:epidemiology / Q000469:parasitology; D002415:Cats / Q000469:parasitology*; D004197:Disease Reservoirs; D004478:Ectoparasitic Infestations / Q000453:epidemiology / Q000469:parasitology / Q000662:veterinary; D006801:Humans; D007303:Insect Vectors / Q000469:parasitology*; D009893:Opossums / Q000469:parasitology; D012286:Rickettsia typhi; D012621:Seasons; D005423:Siphonaptera / Q000382:microbiology*; D013383:Suburban Population; D013781:Texas / Q000453:epidemiology; D014437:Typhus, Endemic Flea-Borne / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology