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Typhus in Galveston

An infectious disease update for you.

Typhus fever, a disease carried by fleas and once thought to be eradicated, is rearing its head in Galveston County, county health officials said on Monday.

The Galveston County Health District reported that 18 cases of typhus fever have been reported so far in 2018, up from 17 reported for all of 2017. The disease has rebounded in other parts of Texas in the last decade.

“I believe we are seeing an increase in reported cases because physicians now know what symptoms to look for,” said Randy Valcin, Galveston County Health District’s director of epidemiology and public health preparedness, in a written statement. “Typhus has been around for a number of years, but physicians are testing more and we’re seeing those results.”

Typhus symptoms, which include fever, headache, muscle pain, anorexia, rash, nausea and vomiting, are often confused with a number of viral ailments. People become infected when they come in contact with infected flea feces through open wounds, scratching and even breathing in the infected feces. Symptoms usually present about 7 to 14 days after exposure to the virus.

Murine typhus is a flea-borne illness, now believed to be carried mostly by opossums and other backyard mammals that spread them to cats and dogs, which then bring them indoors. Historically, typhus was carried by rats, before aggressive use of DDT, a pesticide, in the mid-1940s largely eliminated the problem in most U.S. areas. Before the use of DDT, typhus fever peaked in the United States with 5,400 reported cases. By 1956, there were less than 100 reported cases. The use of DDT has since been banned.

The disease is often mild, and treatable with antibiotics. But left untreated, severe illness can cause damage to one or more organs, including the liver, kidneys, heart, lungs and brain.

Over the last 15 years, typhus has been making a comeback in Texas. In 2017, the Chronicle reported the number of Texas cases rose from 30 in 2003 to 364 in 2016, and the number of Harris County cases from zero to 32. Eight Texas deaths have been attributed to the infection since 2003, with more than a quarter of cases reported to the state health department involve children from 6 to 15 years old.

See here for some background. Like Zika, typhus is a tropical disease, and one reason we’re seeing it here now is because of climate change. Basically, the conditions under which these diseases, and the insects that carry them, now exist in a much broader and less-equatorial range. We can accept that as the new normal or we can try to maybe do something about that, I dunno. Just a thought.

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