|Classification and external resources|
Murine typhus (also called endemic typhus) is a form of typhus transmitted by fleas (Xenopsylla cheopis), usually on rats. (This is in contrast to epidemic typhus, which is usually transmitted by lice.) Murine typhus is an under-recognized entity, as it is often confused with viral illnesses. Most people who are infected do not realize that they have been bitten by fleas.
It is caused by the bacteria Rickettsia typhi, and is transmitted by the fleas that infest rats. While rat fleas are the most common vectors, cat fleas and mouse fleas are less common modes of transmission. These fleas are not affected by the infection. Human infection occurs because of flea-fecal contamination of the bites on human skin. Rats, cats, possums maintain the rickettsia colonization by providing it with a host for its entire life cycle. Rats can develop the infection, and help spread the infection to other fleas that infect them, and help multiply the number of infected fleas that can then infect humans.
In the United States of America, Murine typhus is found most commonly in southern California, Texas and Hawaii. In some studies, up to 13% of children were found to have serological evidence of infection.
Symptoms of endemic typhus include headache, fever, muscle pain, joint pain, nausea and vomiting. 40–50% of patients will develop a discrete rash six days after the onset of signs. Up to 45% will develop neurological signs such as confusion, stupor, seizures or imbalance.
Treatment and prognosis 
Endemic typhus is highly treatable with antibiotics. Most people recover fully, but death may occur in the elderly, severely disabled or patients with a depressed immune system. The most effective antibiotics include tetracycline and chloramphenicol.
See also 
- Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. p. 1130. ISBN 1-4160-2999-0.
- Information on Murine Typhus (Fleaborne Typhus) or Endemic Typhus Texas Department of State Health Services (2005).
- Williams SG, Sacci JB, Schriefer ME, et al. (July 1992). "Typhus and typhuslike rickettsiae associated with opossums and their fleas in Los Angeles County, California". J. Clin. Microbiol. 30 (7): 1758–62. PMC 265376. PMID 1629332.
- "Murine (endemic) Typhus" (PDF). California Department of Public Health. Retrieved 30 May 2012.
- W. Michael Scheld; Richard J. Whitley; Christina M. Marra (25 March 2004). Infections of the Central Nervous System. Lippincott Williams & Wilkins. p. 430. ISBN 978-0-7817-4327-3. Retrieved 24 August 2012.
- "Principles and Practice of Infectious Diseases sixth edition" Gerald L Mandell, John E. Bennett, Raphael Dolin. Elsevier Inc. 2005. pp. 2307
- Current Medical Dianosis & Treatment 1999 ed. Lawrence M. Tierney, Jr., MD, Stephen J. McPhee, MD, Maxine A. Papadakis, MD, Appleton & Lange, 1999. pp.1286 ISBN 0-8385-1550-9
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