Ask the experts
I live in Seal Beach, which is south of Los Angeles. There has been typhus outbreaks in both cities. I thought typhus didn't happen in Western countries. In the history books I've read, it sounds terrible. With our modern medicine and antibiotics, is typhus still deadly? Can typhus kill you?
Early diagnosis and appropriate treatment yield an excellent prognosis for almost all patients with any of the types of typhus (endemic and epidemic being the two main types of the disease).
Delayed, undiagnosed, or untreated typhus has a less promising prognosis, but the prognosis is related to the type. For example, untreated endemic typhus has a death rate under 2% of patients, but untreated epidemic typhus has a death rate that ranges from about 10%-60% of infected patients, with those over 60 years of age having the highest death rates.
Even if the patient does not die, complications that may worsen the prognosis in endemic and epidemic typhus to fair or poor are renal insufficiency, pneumonia, and central nervous system problems.
Physicians recommend antibiotic therapy for both endemic and epidemic typhus infections because early treatment with antibiotics (for example, azithromycin, doxycycline, tetracycline, or chloramphenicol) can cure most people infected with the bacteria. Consultation with an infectious-disease expert is advised, especially if epidemic typhus or typhus in pregnant females is diagnosed. Delays in treatment may allow renal, lung, or nervous system problems to develop. Some patients, especially the elderly, may die.
For more information, read our full medical article on typhus.
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Bechah, Yassina, Christian Capo, Jean-Louis Mege, and Didier Raoult. "Epidemic Typhus." The Lancet Infectious Diseases 8.7 July 1, 2008: P417-426.
Green, J., J. Singh, M. Cheung, et al. "A Cluster of Pediatric Endemic Typhus Cases in Orange County, California." Pediatr. Infect. Dis. 30.2 (2011): 163-165.
Okulicz, J. "Typhus Clinical Presentation." Medscape. July 24, 2017. <https://emedicine.medscape.com/article/231374-clinical>.
United States. California Department of Public Health. "Typhus (Flea-Borne)." Feb. 1, 2019. <https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/Typhus.aspx>.
United States. County of Los Angeles Public Health. "Flea-Borne (Endemic) Typhus." Feb. 7, 2019. <http://www.publichealth.lacounty.gov/acd/VectorTyphus.htm>.