What Is Louse-Borne Typhus (Epidemic Typhus)?

Depending on what has bitten a person, typhus is divided into three types:

1. Louse-borne typhus or epidemic typhus: This is a rare type of typhus that infected body lice can spread. One type of epidemic typhus also spreads with exposure to flying squirrels, but it is considered very rare.
2. Murine or endemic typhus: Fleas bite the infected animals, mainly rats, and then transmit murine typhus to humans. Most cases of murine typhus in the United States are seen in California, Hawaii, and Texas.
3. Scrub typhus: The infected chiggers or the larval mites spread the disease. The disease is usually seen in the rural parts of Southeast Asia, China, Japan, India, and Northern Australia.

The symptoms appear 2 to 10 weeks after exposure to the bacteria. Different types of typhus show different signs and symptoms.

The following are the common symptoms of types of typhus:

• Extremely high fever
• Chills
• Headache
• Body and muscle
• Rashes
• Cough
• Nausea
• Vomiting
• Confusion
• Rapid breathing

Louse-borne or epidemic typhus

The following are the symptoms of louse-borne or epidemic typhus:

• Confusion
• Cough
• Nausea
• Vomiting
• Sensitivity to light 

Murine or endemic typhus

The following are the symptoms of murine or endemic typhus:

• Dull-red rash
• Abdominal pain
• Vomiting
• Loss of appetite
• Stomach pain

Scrub typhus

The following are the symptoms of scrub typhus:

• Confusion or mental illness
• Severe fatigue
• A dark scab in the area of the chigger bite
• Swelling in the lymph nodes

A healthcare provider does a general and physical examination and asks the following:

• Symptoms
• Socioeconomic status and living environment 
• Any recent outbreak of typhus in the living areas 
• Travel abroad

The diagnosis may become difficult because most of the symptoms are similar to those of malaria, dengue, and typhoid symptoms.

For proper diagnosis, the following diagnostic tests are recommended:

• Skin biopsy
• Blood tests
• Western blot test to identify the bacteria
• Immunofluorescence test to identify the typhus antigen in the serum taken from the bloodstream

The effective way to treat all three types of typhus is by using an antibiotic called doxycycline. This antibiotic can be prescribed to any age group and should be given immediately after the symptoms start for effective results.

If the disease is left untreated, it results in serious, life-threatening complications.

The following are a few complications of typhus:

• Inflammation of the brain and spinal cord
• Enlargement of the spleen
• Internal bleeding
• Inflammation of the heart and valves
• Kidney and liver damage
• Decreased blood pressure
• Pneumonia
• Septic shock

There is no specific vaccine to prevent the infection.

A few precautions may help control the transmission of the infection:

• Maintain basic hygiene.
• Stay away from animals or insects that spread the infection.
• Do not leave food or any trash surrounding the house, which may attract the animals such as rats and flying squirrels, which are the major agents causing some types of typhus.