Typhus is caused by one of two types of bacteria: Rickettsia typhi or Rickettsia prowazekii. The form of typus depends on which type of bacteria causes the infection.
Rickettsia typhi causes murine or endemic 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." Lice and fleas of flying squirrels spread the bacteria.
Murine typhus occurs in the southeastern and southern United States, often during the summer and fall. It is rarely deadly. Risk factors for murine typhus include:
- Exposure to rat fleas or rat feces
- Exposure to other animals (such as cats, opossums, raccoons, skunks, and rats)
Rickettsia prowazekii causes epidemic typhus and Brill-Zinsser disease. Brill-Zinsser disease is a mild form of epidemic typhus. It occurs when the disease re-activates in a person who was previously infected. It is more common in the elderly.
Symptoms of murine typhus may include:
- Abdominal pain
- Backache
- Dull red rash that begins on the middle of the body and spreads
- Extremely high fever (105 - 106 degrees Fahrenheit), which may last up to 2 weeks
- Hacking, dry cough
- Headache
- Joint pain (arthralgia)
- Nausea
- Vomiting
Symptoms of endemic typhus may include:
- Chills
- Cough
- Delirium
- High fever (104 degrees Fahrenheit)
- Joint pain (arthralgia)
- 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 headache
- Severe muscle pain (myalgia)
- Stupor
The 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 (petechiae).
