title: Cluster of sylvatic epidemic typhus cases associated with flying squirrels, 2004-2006.
abstract: In February 2006, a diagnosis of sylvatic epidemic typhus in a counselor at a wilderness camp in Pennsylvania prompted a retrospective investigation. From January 2004 through January 2006, 3 more cases were identified. All had been counselors at the camp and had experienced febrile illness with myalgia, chills, and sweats; 2 had been hospitalized. All patients had slept in the same cabin and reported having seen and heard flying squirrels inside the wall adjacent to their bed. Serum from each patient had evidence of infection with Rickettsia prowazekii. Analysis of blood and tissue from 14 southern flying squirrels trapped in the woodlands around the cabin indicated that 71% were infected with R. prowazekii. Education and control measures to exclude flying squirrels from housing are essential to reduce the likelihood of sylvatic epidemic typhus.
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
authors.forename: Alice S
authors.initials: AS
authors.lastname: Chapman
authors.forename: David L
authors.initials: DL
authors.lastname: Swerdlow
authors.forename: Virginia M
authors.initials: VM
authors.lastname: Dato
authors.forename: Alicia D
authors.initials: AD
authors.lastname: Anderson
authors.forename: Claire E
authors.initials: CE
authors.lastname: Moodie
authors.forename: Chandra
authors.initials: C
authors.lastname: Marriott
authors.forename: Brian
authors.initials: B
authors.lastname: Amman
authors.forename: Morgan
authors.initials: M
authors.lastname: Hennessey
authors.forename: Perry
authors.initials: P
authors.lastname: Fox
authors.forename: Douglas B
authors.initials: DB
authors.lastname: Green
authors.forename: Eric
authors.initials: E
authors.lastname: Pegg
authors.forename: William L
authors.initials: WL
authors.lastname: Nicholson
authors.forename: Marina E
authors.initials: ME
authors.lastname: Eremeeva
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Dasch
mesh_terms: D000328:Adult; D000818:Animals; D004197:Disease Reservoirs; D004502:Education, Medical, Continuing; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D010414:Pennsylvania; D012283:Rickettsia prowazekii / Q000302:isolation & purification; D012589:Sciuridae / Q000382:microbiology*; D011795:Surveys and Questionnaires; D014438:Typhus, Epidemic Louse-Borne / Q000150:complications / Q000453:epidemiology* / Q000635:transmission