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Medical Author:

Charles Patrick Davis, MD, PhD

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.

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Medical Editor:

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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In this Article

• Typhus facts
• What is typhus? Are there different types of typhus?
• What is the history of typhus?
• What causes typhus? How is typhus transmitted?
• What are typhus risk factors?
• What are typhus symptoms and signs?
• How is typhus diagnosed?
• What is the treatment for typhus?
• What is the prognosis of typhus?
• Can typhus be prevented?
• Where can people get more information about typhus?
• Find a local Doctor in your town
• Typhus Index

Typhus risk factors include living in or visiting areas where the disease is endemic, such as many port cities where rat populations are high or areas where trash accumulates and hygiene may be low such as disaster zones, homeless camps, poverty-stricken areas, and other similar situations that allow rodent populations to come in close contact with people. These are the same type of conditions that lead to outbreaks of cholera, tuberculosis, and viral diseases like influenza. Spring and summer months are when fleas (and ticks) are most active, but infections can occur any time of the year.

Symptoms of endemic typhus develop within about one to two weeks after initial infection and may include a high fever (about 105 F), headache, malaise, nausea, vomiting, diarrhea, and a rash that begins about four to seven days on the chest and abdomen after the initial symptoms above develop; the rash often spreads. Some patients may also have a cough and abdominal, joint, and back pain. Symptoms may last for about two weeks and, barring complications or death (less than 2% die), symptoms abate.

However, epidemic typhus symptoms, although initially similar to endemic typhus, become more severe. The rash may cover the entire body except the palms of the hands and the bottoms of the feet. Patients may develop additional symptoms of bleeding into the skin (petechiae), delirium, stupor, hypotension, and shock, which can cause their death.