Paging Dr. Frischer: Typhus
In the news we’ve been hearing about rising numbers of cases of typhus in…Santa Monica? Historically, millions of people died from epidemic outbreaks, usually during war, famine or other times of crisis.
And yes, typhus does still exist. There was a record high of 220 cases of typhus detected in Los Angeles County in 2025,and 90% of those infected were hospitalized.
There are different types of typhus found worldwide, each caused by different bacteria. Some are spread by body lice, flying squirrels, or chiggers (young mites). In this country, the predominant strain is Murine typhus, which tends to be milder, and is mainly spread by fleas. These fleas might be found on rats, opossums, and stray cats. The animals carrying the bacteria often appear healthy. The infection begins when the waste produced by fleas enters our body through a bite wound, a scrape in our skin, or from flea waste being rubbed into our eyes.
Typhus is not contagious from human to human. However, in crowded living conditions, infected fleas can spread typhus to more than one person. Symptoms begin within a week or two of infection, and all age groups are at risk. They include high fevers with chills, severe headaches, body aches, nausea or vomiting, cough, stomach pain, swollen lymph nodes, and rash.
Typhus is diagnosed based on symptoms, and whether you live in or have traveled to an area where you might have been infected. A blood test or skin biopsy near the bite can make a definitive diagnosis, however the lab work could take a few weeks.
The best prevention is to avoid fleas, lice and chigger bites. When outdoors in high-risk areas, use insect repellent and cover up as much as possible, including long pants, long-sleeved shirts, and socks. Speak with your veterinarian about preventing fleas on your pets, and keep them indoors as much as possible. Keep rodents away by keeping trash can lids on tight, cleaning up yard debris, and sealing off crawl spaces.
Fortunately, all types of typhus are treatable with antibiotics, and when treated early, have a good prognosis. If left untreated, it’s possible that the symptoms could go away on their own, only to return months or years later. Untreated typhus can lead to blood clots, enlarged spleen, facial paralysis, gangrene, hearing loss, meningitis, myocarditis, optic neuritis, pleural effusion pneumonia, and respiratory failure. 10% to 30% of untreated cases are fatal.
Dr. Alan Frischer is former chief of staff and former chief of medicine at Downey Regional Medical Center. Write to him in care of this newspaper at 10927 Downey Ave., Suite C, Downey, CA 90241.