Typhus Fever: Transmission of Endemic Typhus by Rubbing Either Crushed Infected Fleas or Infected Flea Feces into Wounds

Dyer, R. E.; Ceder, E. T.; Workman, W. G.; Rumreich, A.; Badger, L. F.

doi:10.2307/4580312

Cited by 8 publications

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“…The primary route of transmission for R. typhi is through the inoculation of infected flea feces on abraded skin. 42 , 76 Alternatively, crushed fleas in contact with the skin 76 and aerosols produced from dry flea feces or dry flea tissues could be potential sources of exposure. As detailed by Azad (1990), infection in the flea is initiated when the rickettsiae are ingested and enter the epithelial cells of the midgut.…”

Section: Epidemiology and Ecology Of Murine Typhusmentioning

confidence: 99%

Manifestations and Management of Flea-Borne Rickettsioses

Martinez

Ramírez-Hernández

Blanton

2021

RRTM

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Murine typhus and flea-borne spotted fever are undifferentiated febrile illnesses caused by Rickettsia typhi and Rickettsia felis , respectively. These organisms are small obligately intracellular bacteria and are transmitted to humans by fleas. Murine typhus is endemic to coastal areas of the tropics and subtropics (especially port cities), where rats are the primary mammalian host and rat fleas ( Xenopsylla cheopis ) are the vector. In the United States, a cycle of transmission involving opossums and cat fleas ( Ctenocephalides felis ) are the presumed reservoir and vector, respectively. The incidence and distribution of murine typhus appear to be increasing in endemic areas of the US. Rickettsia felis has also been reported throughout the world and is found within the ubiquitous cat flea. Flea-borne rickettsioses manifest as an undifferentiated febrile illness. Headache, malaise, and myalgia are frequent symptoms that accompany fever. The incidence of rash is variable, so its absence should not dissuade the clinician to consider a rickettsial illness as part of the differential diagnosis. When present, the rash is usually macular or papular. Although not a feature of murine typhus, eschar has been found in 12% of those with flea-borne spotted fever. Confirmatory laboratory diagnosis is usually obtained by serology; the indirect immunofluorescence assay is the serologic test of choice. Antibodies are seldom present during the first few days of illness. Thus, the diagnosis requires acute- and convalescent-phase specimens to document seroconversion or a four-fold increase in antibody titer. Since laboratory diagnosis is usually retrospective, when a flea-borne rickettsiosis is considered, empiric treatment should be initiated. The treatment of choice for both children and adults is doxycycline, which results in a swift and effective response. The following review is aimed to summarize the key clinical, epidemiological, ecological, diagnostic, and treatment aspects of flea-borne rickettsioses.

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Section: Epidemiology and Ecology Of Murine Typhusmentioning

confidence: 99%

Manifestations and Management of Flea-Borne Rickettsioses

Martinez

Ramírez-Hernández

Blanton

2021

RRTM

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“…By the end of 1931, Ceder, Dyer, Rumreich, and Badger demonstrated that feces from infected fleas were capable of transmitting FBT through scratches on the skin of guinea pigs, indicating that a major route of transmission is through inoculation of infected feces into abraded skin or mucous membranes [50,119] (subsequently, it was shown that a flea bite may also transmit the infection [2,39]). In the following year, the same team discovered that the feces of X. cheopis become highly infectious six days after feeding on R. typhi-infected rats.…”

Section: The Epidemiology and Ecology Of Flea-borne Typhus Is Deducedmentioning

confidence: 99%

“…In the following year, the same team discovered that the feces of X. cheopis become highly infectious six days after feeding on R. typhi-infected rats. An inoculum as low as 1/128,000 of a flea produced infection and the fleas remained infectious for at least 42 days [50]. The importance of X. cheopis as a vector of FBT was further solidified when it was determined that rats infested with this flea were 70% more likely to be seropositive for FBT compared to rats infested with other flea species [31].…”

Section: The Epidemiology and Ecology Of Flea-borne Typhus Is Deducedmentioning

confidence: 99%

“…Transmission of rickettsiae from flea to flea does not occur sexually or by contact, nor are the larvae infected by feeding on infected eggs or dejecta [27,48]. Fleas infected with R. typhi retain the infection for at least 52 days; thus, they serve as both vectors and reservoirs [50]. Unlike the situation with Yersinia pestis (the plague bacterium), which is lethal to rats and fleas alike, neither are adversely affected by R. typhi or R. felis [1,3,29].…”

Section: Introductionmentioning

confidence: 99%

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History, Rats, Fleas, and Opossums: The Ascendency of Flea-Borne Typhus in the United States, 1910–1944

Anstead

2020

TropicalMed

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Flea-borne typhus, due to Rickettsia typhi and Rickettsia felis, is an infection causing fever, headache, rash, hepatitis, thrombocytopenia, and diverse organ manifestations. Although most cases are self-limited, 26%-28% have complications and up to one-third require intensive care. Flea-borne typhus was recognized as an illness similar to epidemic typhus, but having a milder course, in the Southeastern United States and TX from 1913 into the 1920s. Kenneth Maxcy of the US Public Health Service (USPHS) first described the illness in detail and proposed a rodent reservoir and an arthropod vector. Other investigators of the USPHS (

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Endemic Typhus Fever of the United States

Dyer¹

1932

JAMA

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Typhus Fever: Transmission of Endemic Typhus by Rubbing Either Crushed Infected Fleas or Infected Flea Feces into Wounds

Cited by 8 publications

References 0 publications

Manifestations and Management of Flea-Borne Rickettsioses

Manifestations and Management of Flea-Borne Rickettsioses

History, Rats, Fleas, and Opossums: The Ascendency of Flea-Borne Typhus in the United States, 1910–1944

Endemic Typhus Fever of the United States

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