Typhus

  • Medical Author:
    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

  • Medical Editor: Mary D. Nettleman, MD, MS, MACP
    Mary D. Nettleman, MD, MS, MACP

    Mary D. Nettleman, MD, MS, MACP

    Mary D. Nettleman, MD, MS, MACP is the Chair of the Department of Medicine at Michigan State University. She is a graduate of Vanderbilt Medical School, and completed her residency in Internal Medicine and a fellowship in Infectious Diseases at Indiana University.

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What is typhus? Are there different types of typhus?

Typhus is a disease caused by bacteria (mainly Rickettsia typhi or R. prowazekii). There are two major types of typhus: endemic (or murine typhus) and epidemic typhus. The bacteria are small and very difficult to cultivate; originally they were thought to be viruses. The disease occurs after bacteria (Rickettsia spp.) are transferred to humans usually by vectors such as fleas or lice that have acquired the bacteria from animals such as rats, cats, opossums, raccoons, and other animals. Endemic typhus (mainly caused by R. typhi) is also termed murine typhus and "jail fever." "Endemic typhus" also means that an area or region has an animal population (usually mice, rats, or squirrels) that has members of its population continually infected with R. typhi that through flea vectors can incidentally infect humans. Epidemic typhus (caused by R. prowazekii) is the more severe form of typhus. It has also been termed recrudescent or sporadic typhus. "Epidemic typhus" also means that a few animals, (usually rats) via lice vectors, can incidentally infect large numbers of humans quickly when certain environmental conditions are present (poor hygiene, poverty, crowded human living conditions) with the more pathogenic R. prowazekii. Epidemic typhus has a milder form termed Brill-Zinsser disease, which occurs when R. prowazekii bacteria reactivate in a person previously infected with epidemic typhus.

There is some confusion surrounding the term "typhus." Many people occasionally equate typhus with typhoid (typhoid fever), which is incorrect. There is confusion for multiple reasons. Both diseases have in common the symptom of high fever, and the major species of Rickettsia that causes endemic typhus is still termed "typhi." However, the causes, transmission, pathology, and treatment of these diseases are quite different. Salmonella spp. causes typhoid fever, and this is unrelated to Rickettsia. Additionally confusing is the term "scrub typhus," which refers to a related but different disease. This disease is related to typhus but is caused by a different genus and species of bacteria and is transmitted by a different vector (see the causes section below). The aim of this article is to inform the reader about the two major worldwide variations of typhus, endemic and the more severe epidemic typhus.

Medically Reviewed by a Doctor on 11/23/2015

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