Murine typhus is caused by Rickettsia typhi and R. felis, which are transmitted to humans by fleas; it is clinically similar to but milder than epidemic typhus, causing chills, headache, fever, and rash.
(See also Overview of Rickettsial and Related Infections.)
Murine typhus is a rickettsial disease.
Animal reservoirs include cats, wild opossums, rats, mice, and other rodents. Rat fleas and probably cat fleas and opossum fleas transmit organisms to humans through bites. Fleas are also natural reservoirs for R. typhi; infected female fleas can transmit organisms to their progeny. Distribution is sporadic but worldwide; the incidence is low but higher in rat-infested areas.
Symptoms and Signs of Murine Typhus
After an incubation of 6 to 18 days (mean 10 days), a shaking chill accompanies headache and fever in patients with murine typhus. The fever lasts about 12 days; then temperature gradually returns to normal.
The rash and other manifestations are similar to those of epidemic typhus but are much less severe. The early rash is sparse and discrete.
Mortality is low but is higher in older patients.
Diagnosis of Murine Typhus
History and physical examination
Biopsy of rash with fluorescent antibody staining to detect organisms
Acute and convalescent serologic testing (serologic testing not useful acutely)
Polymerase chain reaction (PCR)
For details, see Diagnosis of Rickettsial and Related Infections.
Treatment of Murine Typhus
1). Research indicates that short courses of doxycycline (5 to 10 days, as used for rickettsial disease) can be used in children without causing tooth staining or weakening of tooth enamel (2).
For details of treatment, see Treatment of Rickettsial and Related Infections.
Treatment references
1. Centers for Disease Control and Prevention: Information for Healthcare Providers, Typhus Fevers
2. Todd SR, Dahlgren FS, Traeger MS, et alJ Pediatr 166(5):1246-51, 2015. doi: 10.1016/j.jpeds.2015.02.015
Prevention of Murine Typhus
Incidence of murine typhus has been decreased by reducing rat and rat flea populations. No effective vaccine exists.
Key Points
Murine typhus is transmitted to humans by fleas.
Symptoms begin with a shaking chill, headache, and fever; the rash and other manifestations are similar to those of epidemic typhus but are much less severe.
