A 74-year-old man who returned to Thiruvananthapuram, Kerala, from Cambodia has been diagnosed with Murine Typhus, a flea-borne illness. After experiencing severe body pains, fatigue, and loss of appetite, he sought treatment at a private hospital, where tests revealed impaired liver and kidney function. While initial tests for flea fever were negative, Murine Typhus was confirmed following further testing at CMC Hospital in Vellore. The state health department reports that the patient is improving under hospital care, reassuring the public that the disease is not contagious.
To understand more about this disease, OnlyMyHealth team spoke with Dr Roohi Pirzada, MBBS, Consultant Physician from Mumbai. She explained, "Murine typhus is a rickettsial disease caused by Rickettsia typhi, a bacterium that spreads to humans through infected fleas, commonly the oriental rat flea (Xenopsylla cheopis) or cat fleas," she explains. The condition is typically transmitted when a person comes into contact with flea faeces, either through rubbing it into cuts or scratches or by inhaling infected dry faeces, which can happen when fleas are present in the environment.
What Causes Murine Typhus?
The root cause of murine typhus lies in the interaction between humans and fleas that infest rodents, especially rats and mice. Fleas act as vectors, transferring the bacteria from these animals to humans. It is most commonly seen in tropical and subtropical regions, where the flea population thrives due to the climate. Kerala, known for its warm and humid environment, provides favourable conditions for flea-borne diseases to occur.
"Murine typhus, although not widely known, can have serious health implications if not diagnosed and treated promptly. The symptoms are often vague and may resemble common viral infections, which can delay diagnosis," adds Dr Pirzada.
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Recognising the Symptoms
The symptoms of murine typhus can be quite debilitating. According to Dr Pirzada, "The primary symptoms include a very high-grade fever, often reaching 105°F or higher, along with joint pain, malaise, body aches, nausea, vomiting, and muscle pains. Some individuals may also develop a rash a few days after the onset of fever."
Given that the symptoms of murine typhus overlap with those of more common febrile illnesses, it can be challenging to identify without proper medical evaluation. Diagnosis often involves considering the patient's exposure to potential flea-infested environments, such as areas where stray animals, rodents, or wildlife are present. "The diagnosis is mostly made based on symptoms and a history of exposure. A PCR test or immunofluorescent assay (IFA) can confirm the diagnosis," Dr Pirzada elaborates.
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Prevention and Treatment
Preventing murine typhus primarily involves minimising contact with fleas, rodents, and their environments. Simple measures such as keeping homes and surroundings clean, using flea control for pets, and avoiding areas known for flea infestations can reduce the risk of infection. "If you have pets, it's essential to discuss flea control measures with a veterinarian, such as flea collars or regular treatments. Additionally, live trapping of rats and other precautions can prevent flea exposure," suggests Dr Pirzada.
While there is no vaccine available for murine typhus, early diagnosis and appropriate treatment can significantly improve outcomes. "The best and most effective treatment is the antibiotic doxycycline," says Dr Pirzada. "In cases where resistance or allergies are a concern, ciprofloxacin can serve as a good alternative." She notes that the illness typically lasts around two weeks but may extend for months if complications arise or if treatment is delayed.
Conclusion
While murine typhus remains a relatively rare condition in India, increased awareness of its symptoms and transmission routes is crucial, especially in rural and tropical regions where the risk of flea exposure is higher.
Dr Pirzada concluded by saying, "Murine typhus is a preventable and treatable disease, but early recognition and treatment are key to avoiding severe complications. People should be cautious, especially in areas with stray animals, rodents, and fleas, and take preventive measures to protect themselves."