A flea-borne disease that can lead to limb amputations is on the rise in the US, an official investigation suggests.
Researchers at the Centers for Disease Control and Prevention (CDC) found that the number of typhoid cases caused by fleas has risen more than 450 percent since 2010 in Los Angeles County (LAC), California.
CDC doctors said they have not noticed the disease becoming more deadly, but it is a possibility and should be monitored. Prior to 2022, the most recent flea-borne typhoid-associated death in the area was in 1993, but there were three fatalities between June and October last year.
Flea-borne typhoid, also known as mouse typhoid, is a disease caused by the bacteria Rickettsia typhi and possibly Rickettsia felis, which are transmitted by fleas.
The CDC calls it a moderately severe disease, but it can be fatal in some cases because it can lead to things like septic shock.
Texas is also experiencing a “significant increase” in cases statewide, the CDC said. In June 2023, a Texan man had his hands and parts of his feet amputated after contracting typhus from a flea, likely while working as a pet sitter.
The chart above shows the increase from 31 cases in 2010 to 171 in 2022. It excludes the cities of Pasadena and Long Beach, and includes confirmed, probable, and suspected cases
Michael Kohlhof, a Texan handyman, pet sitter and artist, lost his arms down to his forearms, his toes and parts of his feet after contracting typhus from a flea bite
The Centers for Disease Control and Prevention (CDC) — which revealed the increase today — warned that clinicians should consider flea typhoid in any patient with a fever, headache or rash.
It said the rise could be due to an increase in rats and other rodents in LAC, as well as the prevalence of the cat flea.
Fleas that carry typhoid live on animals, especially feral and stray cats, rats and possums, but do not make their hosts unwell.
The bacteria spread when feces from an infected insect contaminate someone’s cut or scrape as the insect sucks its blood.
If the person scratches the bite area, the bacteria can pass from the stool into the bloodstream. Bacteria can also be rubbed into someone’s eyes or, in rare cases, inhaled.
Symptoms of the disease include fever, headache, rash, muscle aches, fever, and chills. In severe cases, patients may be hospitalized because of hepatitis or internal bleeding.
Flea typhus is endemic to parts of LAC and Orange County. The disease is also common in Texas and Hawaii.
About 200 cases occur in the US each year, particularly in coastal areas.
Flea-borne typhoid, also known as mouse typhoid, is a disease caused by the bacteria Rickettsia typhi and possibly Rickettsia felis, which are transmitted by fleas
Symptoms then appear six to fourteen days later. Typhoid can be treated with antibiotics, with most people recovering within a few days.
Worldwide, between two and four percent of people who do not receive treatment die.
Typhoid can be prevented by avoiding contact with fleas, mites, ticks and lice, but there is currently no vaccine for the disease.
The CDC warned that the death toll could be even higher, as patients in LAC with flea-borne typhoid were not tracked from the hospital after they were discharged, meaning some deaths could have been missed.
One of the dead, referred to as patient A, was a 68-year-old Hispanic man. He went to the ER in June 2022 after having a fever and muscle weakness for three days.
He died after 30 days in the hospital due to flea-borne typhoid-induced hemophagocytic lymphohistiocytosis (HLH) and septic shock.
HLH is a rare immune system disease for which the man received chemotherapy.
Doctors believe the man may have been exposed to rodents and fleas because his home was near a highway and garbage.
The second patient to die was a 49-year-old Hispanic woman who went to an emergency room in August 2022 after experiencing a headache and fever for two days.
She experienced multi-organ failure and died after spending three days in the hospital.
Tests done on her body after she died showed that she had traces of the Rickettsia bacteria in the small blood vessels of her heart and parts of her liver.
Doctors said she may have been exposed to fleas from stray kittens living in the patient’s backyard.