Department of Public Health - Acute Communicable Disease Control

Flea-Borne (Endemic) Typhus

Typhus refers to a group of infectious diseases that are caused by rickettsial organisms and result in an acute febrile illness. The principle diseases of this group are epidemic (or louse-borne) typhus, flea-borne (or endemic) typhus, and scrub typhus.

Flea-borne typhus (sometimes called murine typhus) is the only one of these diseases naturally occurring in LA County and is caused by Rickettsia typhi bacteria. Flea-borne typhus can spread to humans from bacteria found in infected fleas. Infection happens when the feces from infected fleas are rubbed into cuts or scrapes in the skin or rubbed into the eyes.

Symptoms can start within two weeks after contact with the infected flea and include high fever, headache, chills, and body aches. A rash can appear on the chest, back, arms, or legs. In rare cases, there may be swelling at the lining of the brain (meningitis) and heart valves (endocarditis). Fatalities are uncommon, occurring in less than 1% of cases. The disease is typically mild in young children. Typhus infection is not vaccine preventable, but can be treated with antibiotics.

News and Updates:

Letter to Physicians: Vector-borne Disease Risk for Los Angeles County Residents, August 2023
Report: Fleaborne Typhus–Associated Deaths — Los Angeles County, California, 2022
LAC DPH Health Advisory: Increases of Flea-Borne Typhus (11-16-22)
LAC DPH Health Alert: Outbreaks of Flea-Borne Typhus (12-2-21)
Letter: Letter to Mayors and City Managers--Guidance on actions for cities to help prevent endemic flea-borne typhus infections (3-22-19)
Press Release: Update on Flea-Borne Typhus in Los Angeles County (2-7-19)
LAC DPH Health Alert Update: Outbreaks of Flea-Borne Typhus Los Angeles County (10-12-18)
LAC DPH Health Alert: Outbreak of Flea-Borne Typhus in Downtown Los Angeles (10-4-18)
Press Release: Public Health Reports Several Cases of Flea-Borne Typhus (10-4-18)

Typhus Data:

Resources:

Typhus Frequently Asked Questions

English / Spanish

Typhus Tips for Prevention

English / Spanish

Occupational Health FAQs
English / Spanish

Flea-Borne Typhus Flyer
English / Spanish

Reporting
Flea-borne typhus and other rickettsial infections are reportable in California. Reporting of cases guides the Los Angeles County Department of Public Health to target surveillance activities and health education. A Confidential Morbidity Report (CMR) can be used to file a report. The report is available as an online fillable PDF. The CMR may be faxed to the DPH Morbidity Unit at (888) 397-3778 or (213) 482-5508. You may also report cases by telephone during normal business hours from 8:00 a.m. to 5:00 p.m. to (888) 397-3993. For cases among residents of the cities of Long Beach or Pasadena, please contact their local health departments.

Testing: Typhus Testing Information for Health Professionals at the LAC DPH Laboratory

Special Studies Report (2015): Multi-Agency Response to a Flea-Borne Typhus Outbreak Associated with a Mobile Home Community

Additional Resources

Flea-borne Typhus Frequently Asked Questions English Spanish
Flea-borne Typhus: Protect Yourself, Protect Your Neighbors English Spanish

CDC Fact Sheet - Flea-borne Typhus: What you need to know English Spanish Korean Japanese Tagalog Chinese
Typhus Tri-fold Informational Brochure

Typhus Cases by Year, Los Angeles County 2001-2014

Los Angeles County: Annual Morbidity Reports (2001-2016)

LAC: Reported Cases of Selected Diseases (2011-2016)

LAC: Reported Cases of Selected Diseases (2005-2010)

LAC: Reported Cases of Selected Diseases (1999-2004)

ACDC: A Manual of Department Rules, Regulations and Control Procedures (B73)

Typhus Cases, LAC Map: 2014

Typhus Cases, LAC Map: 2000-11

Murine Typhus: An Unrecognized Suburban Vectorborne Disease, Civen, Rachel, and Ngo, Van; Clinical Infections Diseases 2008;46:913-8

A Suburban Neighborhood Outbreak of Murine Typhus - South Pasadena, May 2005 (2005 Special Study)

CDPH: Flea-borne Typhus