Condition 101 About Typhus

What is the definition of Typhus?

Typhus is a bacterial disease spread by lice or fleas.

What are the alternative names for Typhus?

Murine typhus; Epidemic typhus; Endemic typhus; Brill-Zinsser disease; Jail fever

What are the causes for Typhus?

Typhus is caused by two types of bacteria: Rickettsia typhi or Rickettsia prowazekii.

Rickettsia typhi causes endemic or murine typhus.

  • Endemic typhus is uncommon in the United States. It is usually seen in areas where hygiene is poor, and the temperature is cold. Endemic typhus is sometimes called "jail fever." The bacteria that cause this type of typhus is usually spread from rats to fleas to humans.
  • Murine typhus occurs in the southern United States, particularly California and Texas. It is often seen during the summer and fall. It is rarely deadly. You are more likely to get this type of typhus if you are around rat feces or fleas, and other animals such as cats, possums, raccoons, and skunks.

Rickettsia prowazekii causes epidemic typhus. It is spread by lice.

Brill-Zinsser disease is a mild form of epidemic typhus. It occurs when the bacteria become active again in a person who was previously infected. It is more common in older adults.

What are the symptoms for Typhus?

Symptoms of murine or endemic typhus may include:

  • Abdominal pain
  • Backache
  • Dull red rash that begins on the middle of the body and spreads
  • Fever, can be extremely high, 105°F to 106°F (40.6°C to 41.1°C), that may last up to 2 weeks
  • Hacking, dry cough
  • Headache
  • Joint and muscle pain
  • Nausea and vomiting

Symptoms of epidemic typhus may include:

  • High fever, chills
  • Confusion, decreased alertness, delirium
  • Cough
  • Severe muscle and joint pain
  • Lights that appear very bright; light may hurt the eyes
  • Low blood pressure
  • Rash that begins on the chest and spreads to the rest of the body (except the palms of the hands and soles of the feet)
  • Severe headache

The early rash is a light rose color and fades when you press on it. Later, the rash becomes dull and red and does not fade. People with severe typhus may also develop small areas of bleeding into the skin.

What are the current treatments for Typhus?

Treatment includes the following antibiotics:

  • Doxycycline
  • Tetracycline
  • Chloramphenicol (less common)

Tetracycline taken by mouth can permanently stain teeth that are still forming. It is usually not prescribed for children until after all of their permanent teeth have grown.

People with epidemic typhus may need oxygen and intravenous (IV) fluids.

What is the outlook (prognosis) for Typhus?

People with epidemic typhus who receive treatment quickly should completely recover. Without treatment, death can occur, with those over age 60 having the highest risk of death.

Only a small number of untreated people with murine typhus may die. Prompt antibiotic treatment will cure nearly all people with murine typhus.

What are the possible complications for Typhus?

Typhus may cause these complications:

  • Renal insufficiency (kidneys cannot function normally)
  • Pneumonia
  • Central nervous system damage

When should I contact a medical professional for Typhus?

Call your provider if you develop symptoms of typhus. This serious disorder can require emergency care.

How do I prevent Typhus?

Avoid being in areas where you might encounter rat fleas or lice. Good sanitation and public health measures reduce the rat population.

Measures to get rid of lice when an infection has been found include:

  • Bathing
  • Boiling clothes or avoiding infested clothing for at least 5 days (lice will die without feeding on blood)
  • Using insecticides (10% DDT, 1% malathion, or 1% permethrin)


Blanton LS, Dumler JS, Walker DH. Rickettsia typhi (murine typhus). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, Updated Edition. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 192.

Blanton LS, Walker DH. Rickettsia prowazekii (epidemic or louse-borne typhus). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, Updated Edition. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 191.

Raoult D. Rickettsial infections. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 327.

Top Global Doctors For Typhus

Manisha Biswal
Chandigarh, CH, IN
Stuart D. Blacksell
Oxford, ENG, GB
Daniel H. Paris
Basel, BS, CH
In O. Sun
Jeonju, KR
Stephen G. Baker
Cambridge, ENG, GB
Buddha Basnyat
Lalitpur, WR, NP

Latest Advances On Typhus

  • Condition: Scrub Typhus
  • Journal: JAMA network open
  • Treatment Used: Antibiotics
  • Number of Patients: 888
  • Published —
This study compared the effectiveness and safety of different antibiotics for the treatment of scrub typhus (form of typhus spread to people through bites of infected chiggers).
  • Condition: Scrub Typhus complicated with Acute Respiratory Distress Syndrome
  • Journal: The heart surgery forum
  • Treatment Used: Extracorporeal Membrane Oxygenation
  • Number of Patients: 1
  • Published —
This case report describes a patient with scrub typhus that was complicated with acute respiratory distress syndrome and was treated using extracorporeal membrane oxygenation.

Clinical Trials For Typhus