Flea-Borne Typhus Reaches Epidemic Proportions in Southern California

Los Angeles County in California is beset by a major outbreak of typhus—so much so that area health officials have called it an epidemic, with no signs that it’s going to abate any time soon. Pasadena, CA has seen 20 cases, mostly in the past 2 months; in an average year, they might see five cases. Long Beach has confirmed 12 cases, double the typical annual number, with more than 2 months left in the year. Nine cases have been reported throughout the rest of the county. Given that Los Angeles is one of the most heavily traveled cities in the U.S., for both domestic and international travelers, urgent care providers in every corner of the country should be vigilant for patients complaining of fever, headache, chills, and muscle aches 6 to 14 days after a flea bite. Typhus is diagnosed through a combination of clinical symptoms and a blood test. Most cases respond to azithromycin, doxycycline, tetracycline, or chloramphenicol, though many of the patients in California have required hospitalization.