Murine typhus is caused by the bacteria Rickettsia typhi and is usually transmitted through fleas, particularly the Oriental rat flea and the cat flea, according to the Centers for Disease Control and Prevention (CDC).

A 75-year-old Kerala man, who recently returned from Vietnam and Cambodia, has been diagnosed with Murine Typhus. After experiencing severe body pain and fatigue, the patient sought medical attention. Initial tests for flea-borne and rat-related diseases were inconclusive, but further examinations revealed deteriorating liver and kidney functions. Based on his travel history, doctors suspected Murine Typhus, marking the first recorded case of the rare disease in the state, according to medical reports.

What is murine typhus?

According to the Centers for Disease Control and Prevention (CDC), murine typhus is caused by the bacteria Rickettsia typhi, primarily transmitted through fleas, especially the Oriental rat flea (Xenopsylla cheopsis) and the cat flea (Ctenocephalides felis).

Fleas become carriers after feeding on infected animals like rats, cats or opossums, and remain infectious for life. When a flea bites a person or animal, the bacteria-laden flea faeces, also known as flea dirt, can enter the body through the bite wound or other skin breaks, potentially leading to infection.

The bacteria can also be inhaled or introduced into the eyes, but person-to-person transmission does not occur.

Although rare in India, similar infections have previously been reported in regions such as the Northeast, Madhya Pradesh and Jammu and Kashmir.

Symptoms of murine typhus

Symptoms of murine typhus usually manifest within three to 14 days following exposure to infected fleas or flea faeces, although many individuals may be unaware that they have been bitten or have come into contact with flea dirt, states the CDC.

Certain factors can increase the risk of infection, such as spending time outdoors or interacting with specific animals, particularly rats, opossums or stray cats.

Common signs of the illness include fever and chills, body aches and muscle pain, headaches, loss of appetite, nausea, vomiting, stomach pain, cough and a rash, which usually appears around day five and affects about half of those infected.

While severe cases can occur, fatalities are rare, estimated at less than 1% of all instances. Most cases can be effectively treated with antibiotics, and nearly all patients recover completely. However, if left untreated, the disease may lead to hospitalisation, severe illness, organ damage, or even death.

Diagnosis and treatment

In the case of the Kerala patient, doctors suspected murine typhus due to the patient’s travel history and deteriorating liver and kidney functions. While initial tests were inconclusive, the diagnosis was confirmed using Next Generation Sequencing (NGS) technology, which identifies microbial DNA.

According to the CDC, in the initial week of illness, the symptoms can mimic those of various other diseases. If you experience any of the mentioned symptoms, it is crucial to consult your healthcare provider.

Be sure to inform them about any potential exposure to fleas, domestic rodents like rats and mice, or stray animals such as cats. Your healthcare provider may recommend a blood test to detect the bacteria responsible for murine typhus or to check for antibodies indicating recent exposure.

Treatment

Currently, no vaccine is available for Murine Typhus. It’s treated with the antibiotic doxycycline, which is safe for individuals of all ages, according to the CDC. For optimal results, antibiotics should be administered promptly after the onset of symptoms, as early treatment leads to a quick recovery. While the disease is usually self-limiting, doxycycline can reduce the duration of illness.

If left untreated, fever may persist for two to three weeks, and the condition could become severe, with symptoms varying significantly in intensity. Though rare, murine typhus can be fatal in certain cases, and there is no evidence to suggest that chronic infections occur.

Prevention

Though there is no vaccine yet to prevent murine typhus, you can reduce your risk by avoiding contact with fleas. Keep your pets flea-free by consulting your veterinarian about appropriate flea control products, such as collars, oral medications or topical treatments.

To deter rodents, maintain a clean environment by storing food in sealed containers, removing clutter, and sealing entry points in your home. Additionally, avoid interactions with stray animals, and always wear gloves when handling sick or dead animals.

Source: cnbctv18