Oh Fleas, Now There Is A Typhus Outbreak In Los Angeles

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Xenopsylla cheopis, Oriental rat flea, with a proventricular plague mass, 1981. During feeding, the flea draws viable Y. pestis organisms into its esophagus, which multiply and block the proventriculus just in front of the stomach, later forcing the flea to regurgitate infected blood unto the host when it tries to swallow. Image courtesy CDC. (Photo by Smith Collection/Gado/Getty Images).

Fleas bite and aren’t potty trained. That’s why there’s now an outbreak of typhus in downtown Los Angeles, as announced by the Los Angeles Department of Health.

Here’s a CBS Los Angeles news segment on the outbreak:

Since July, there’s been 9 cases of typhus in Los Angeles, specifically Pasadena, which qualifies as an outbreak. That brings the number of reported cases for 2018 to 20 for Pasadena and 12 for  Long Beach, California, as Dennis Romero and Andrew Blankstein reported for NBC News. For both places, that’s been over twice what is normally expected. Yes, it’s been literally a more poopy year in the Los Angeles area, and there is still 3 more months to go in this year. How so? Read on.

Mind you, this isn’t epidemic typhus, which can be caused by the bacteria Rickettsia prowazekii and spread by body lice, or scrub typhus, which can be caused by the bacteria  Orientia tsutsugamushi and spread by chiggers (larval mites). Nah, this is flea-borne or murine typhus, which can be caused by Rickettsia typhi or Rickettsia felis bacteria and can be spread by, you guessed it, fleas. Its called murine because rat fleas (Xenopsylla cheopis) most commonly carry these bacteria, followed by cat fleas (Ctenocephalides felis). The online dictionary,, defines murine as “belonging or pertaining to the Muridae, the family of rodents that includes the mice and rats.” Therefore, if anyone calls you “murine” or invites you to a “murine” party, watch out. 

Now here’s the poop. You can get typhus when a flea carrying the bacteria bites you or infectious flea poop gets rubbed into breaks in your skin or mucous membranes like your eyes. Fleas typically don’t use tiny little toilets when they go Number 2. They can just “bust a grumpy” right on your skin. As if that weren’t rude enough, they can bite you at the same time so that the poop gets rubbed into your wound, allowing whatever bacteria is in their poop to access your bloodstream. Biting you and pooping on you are not the marks of friendship, in most cases.

Once you are infected with the bacteria, symptoms if they do occur, usually arise in about 1 to 2 weeks. Symptoms can include a suddenly occurring fever, headache, chills, muscle aches, abdominal pain, or vomiting that typically last a few days. You may also develop a maculopapular rash, which means a rash that’s both flat and bumpy. Symptoms can get so bad that they require hospitalization, which has been the case for all 9 cases in Pasadena. Severe typhus can lead to problems with your liver, kidneys, lungs, eyes, heart, or brain, all quite important organs.

If you are older or have a deficiency of the G6PD enzyme, you may be at higher risk for more severe disease. Fortunately, death occurs in only about 2% to 4% of people who are not treated. So far, there haven’t been any deaths from this outbreak in Los Angeles.

Besides rats and cats, possums can also carry the bacteria that cause typhus. Fleas can get the bacteria by biting these infected animals and then transfer them to you. (Photo by Suzanne Kreiter/The Boston Globe via Getty Images)

Keep in mind that the number of reported cases is always less the number of actual cases. It’s not as if a notification appears on your forehead, “you’ve got typhus and 3 new likes on Instagram,” when you are infected. Many people may not realize that they have typhus, especially if they have mild or no symptoms, and never see a doctor. Plus, a doctor has to recognize typhus and report it to public health officials for a case to be reported.

There is treatment for typhus: the antibiotic doxycycline. Early treatment, as soon as symptoms appear, can help you recover quickly. But if you think you have typhus, see your doctor. Don’t just assume that you have typhus because you play with flea poop and then pop antibiotics as if they were candy.   

How do you prevent typhus? There is no vaccine yet for anti-vaxxers to spread rumors and conspiracies about. Instead, the California Department of Public Health says “the key to preventing flea-borne typhus is to avoid direct contact with fleas,” which, of course, makes perfect sense. They also urge you to “discourage rats, opossums, feral cats, and other wild animals from visiting or living around your home.” Thus, if you are going to have a party, cross those rats and feral cats off your eVite list. Also, don’t leave food or garbage exposed outside, trim vegetation around buildings, keep your pets flea free. And don’t let Garfield roam the neighborhood looking for fleas.

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