Fourteen confirmed cases and one suspected case of Murine typhus, a flea-borne bacterial illness, have been identified in Central Texas. Typhus is a bacterial infection that causes high fever, sometimes including chills, headache and a rash. Although it responds to antibiotics, failure to treat can land sufferers in the hospital with severe illness.

"A person with prolonged fever, especially if it includes headache and a rash, should be evaluated by a physician if it hasn't improved by the end of four days," says Pat Crocker, DO, medical chief of staff for the Dell Children's Medical Center of Central Texas emergency department. "Common things being common, the illness is more likely to be a prolonged viral infection, middle ear or sinus infection or even pneumonia. But after four full days of fever, it's appropriate to look a little deeper."

Typhus is usually spread by fleas that live on an infected host animal. Hosts primarily include rats, although they are also sometimes found on mice, feral cats, raccoons and opossums.

More common to South Texas, typhus is less often found in Central and North Texas, except for this year. Last year, there were only two cases of Murine typhus here, according to the Austin Travis County Health Department.

"I don't think there's cause for huge concern, although both physicians and patients need to be aware of it," says Dr. Crocker. "It's of interest because Murine typhus has not been reported in our area in any significant numbers for quite some time. This particular outbreak appears to be confined to one small cluster of cases in several Central Austin zip codes."

Currently affected zip codes include 70702, 78705, 78722, 78723,78728 and 78731.

Centers For Disease Control Investigating

A team from the Centers For Disease Control is currently in Austin to research the typhus outbreak to help understand which animals are hosts to these fleas.

"They are actually looking at recent weather conditions. It's been hot and dry this summer. They've noticed all the construction in the city which may have forced animals to look for new sources of water. They are also interested in recent big storms link the one we had earlier in the summer," says Carole Barasch, spokesperson for the Austin Travis County Health and Human Services Department.

Carole reports the researchers are trapping different types of animals including raccoons, opossums and rats for samples to be tested by the CDC.

"The CDC is here to help get answers. They are looking to confirm that it is Murine typhus. Once confirmed, that would help us understand which animals are hosts to the fleas. We've alerted area doctors and health care professionals so they will be more aware when diagnosing of high fever, chills, a rash and things like that. We don't want people to be hospitalized. Antibiotics are an effective treatment," she adds.

What Is Murine Typhus?

This type of infection is called a rickettsial disease, caused by a type of bacteria. Most of these cases occur in South Texas, but recently several have been reported in other parts of the state including Travis County. Rats and their fleas both can host and transmit the disease organism. Other animals, such as opossums and domestic cats may be involved as well. Rat fleas and cat fleas are the most common sources of transfer of the disease from one host to another.

Exposure Mechanism

The typhus organism can enter the body either from a bite or from scratching the bite area. It is also possible to get it by inhaling contaminated dried flea feces, although that is not as common as with a flea bite. The usual incubation period is 6 to 14 days.

Common Symptoms

Initial symptoms of the disease may include headache, fever, nausea and body aches. Five to six days after the initial symptoms, an individual may develop a rash on the trunk of the body that spreads to the arms and legs. Left untreated, the disease can last for several months. A doctor can test your blood for typhus, although test results generally are not available for several days.

Recommended Treatment

If you have an illness with fever more than four full days, consult a doctor. Murine typhus is easily treated with antibiotics, but those who wait too long may need to be hospitalized. Once you recover from the disease, you won't get it again.

Prevention Tactics

• Clean your yard. Rodents, opossums and stray cats can't live where there is no shelter. Remove brush and trash, keep grass mowed and keep firewood off the ground.
• Do not leave pet food out at night.
• Prevent rodents from living in your house with a rodent control program.
• Treat for fleas before you begin rodent control so that when the rodents die, the fleas will not search for new hosts, including those who live in the area.
• If you own pets, apply flea control regularly. Your animals can bring home fleas if they come into contact with them. Check with your veterinarian about safe products for your pet.

For more information, check the Texas Department of Health Services Web site .

Patrick J. Crocker, DO
Emergency Service Partners, PA

Dr. Crocker is Medical Chief of Staff for Dell Children's Medical Center of Central Texas. He is a graduate of the University of Health Sciences College of Osteopathic Medicine and Surgery in Des Moines, Iowa. In addition to his pediatric role, he served as Medical Chief for University Medical Center at Brackenridge for more than 20 years.

Ask GoodHealth.com Question

I've heard a lot about typhus recently. Should I be concerned?

Typhus is a bacterial infection transmitted by fleas living on an infected host animal. Hosts can include rats, feral cats, raccoons or opossums. Although symptoms can resemble other illnesses, often virus illness, they often don't have the usual signs of a virus, including runny nose, cough or sore throat. A person with prolonged fever but without these other signs should check with a doctor, particularly if it is associated with a rash.

I don't think there's cause for huge concern. Both physicians and patients need to be aware of it. This is the first time we've had this infection in Central Texas in small, but still significant, numbers. Patients with unexplained fever conditions should be evaluated

You can prevent exposure if you treat your domestic animals or your home for fleas and keep your yard clean and free of debris.