What Is Typhus?

Typhus is type of infection caused by exposure to rickettsia bacteria

Typhus is a group of bacterial diseases that are developed when a person becomes infected with rickettsia bacteria. The zoonotic illness is transferred to humans by an infected animal and typical carriers of the bacteria include fleas, mites, and lice.

The infection can spread through the entire bloodstream and disrupt the proper function of all parts of the body, including the central nervous system.

Although the disease is more common in underdeveloped areas, it can be found all over the world. Although uncommon America, there have been documented cases in parts of the United States including California.

Typhus is considered one of the oldest recorded diseases and was found to have plagued certain populations as far back as the 18th century. The three different types of typhus include epidemic, endemic, or scrub typhus, and the type of infection will depend on what species it came from.

Endemic, or murine typhus, it transmitted through infected fleas, epidemic or louse typhus is contracted through body lice, and scrub typhus is transmitted from infected mite larvae.

Rat on cobbled street in Frankfurt, Germany
Pierre Aden/Eye Em

Types of Typhus

Since typhus presents itself differently depending on the cause and type of the infection, let’s take a more in-depth look at the different strains of the bacterial disease and what each does to the human body.

Murine Typhus (Endemic)

Found mostly in tropical and subtropical climates, endemic typhus is spread through fleas found on rodents. The specific bacteria responsible for the infection is called Rickettsia typhi. The bacteria depend entirely on rodents for its complete lifecycle and thus rely heavily on those populations to thrive.

The bacteria live in the gut of the flea and are excreted through feces. When the living bacteria in the feces manage to enter the bloodstream of a mammal, infection occurs.

Louse Typhus (Epidemic)

Epidemic typhus is spread through infected body lice populations and can be found worldwide, although it is more common in Asia, parts of Africa, and Mexico. The number of cases is higher in areas where sanitation efforts are low and population numbers are high.

The specific bacteria that causes this type of the disease is called the Rickettsia prowazekii. It is generally transmitted to lice when they feed on infected hosts.

Cases in the United States have been attributed to infected flying squirrel populations. The bacteria survive in the feces of lice and are spread when fecal matter enters the human bloodstream. But it can also be spread via inhalation.

Scrub Typhus (Bush Typhus)

Bush typhus is found in rural areas of northern Australia, Southeast Asia, India, Indonesia, Japan, and China. This type of infection is caused by the Orientia tsutsugamushi bacteria by chiggers or larvae mites.

Scrub typhus can be contracted through both direct feeding and through the fecal intrusion into the bloodstream. Also known as tsutsugamushi disease, this infection can be severe and potentially fatal.

Typhus Symptoms

Depending on the type of bacteria driving the infection, the symptoms may vary. They can be either mild or severe, depending on the length of the infection, whether treatment was delayed, and the level of health of the host.

Scrub Typhus

In the case of scrub typhus, symptoms include:

  • Headaches
  • Fever
  • Chills
  • Body and muscle aches
  • A scab at the site of the bite
  • Mental and cognitive changes
  • Coma
  • Inflammation of lymph nodes
  • Skin rash

In more grave cases of scrub typhus, neurological symptoms can appear and include:

Louse Typhus

Symptoms of louse typhus include:

  • Chills
  • Muscle aches
  • Fatigue
  • Headache
  • High fever
  • Skin rash that spreads from the back to the rest of the body
  • Vomiting
  • Sensitivity to light
  • Mental confusion

Other more serious symptoms can occur in severe cases of the infection including:

The mortality rate for those infected with louse typhus can be as high as 60% when left untreated and as low as 5% when treated with antibiotics.

Murine Typhus

Murine typhus symptoms are categorized as mild and some people who contract the illness can recover without any treatment at all. Those symptoms include:

  • Body aches and pain
  • Cough
  • Fever and chills
  • Gastrointestinal symptoms such as nausea, loss of appetite, stomach pain, and vomiting
  • Rash

In very rare cases, when the bacteria invade organs such as the heart, brain, kidney, liver, and lungs it can leave lasting damage. The infection has been known to lead to acute respiratory distress syndrome, a serious lung condition that can cause a lack of oxygen intake and death.

Other severe complications that can occur in a case of murine typhus include:


Although the chances of you contracting typhus are quite low, especially if you haven’t just spent time in a high-risk area, it doesn’t hurt to know what you may be in for if you suspect an infection.

When you contact your health care provider, they will likely determine whether or not there’s reason enough to examine your symptoms and then perform further tests. If they do opt for diagnostics, some examples that they might perform include:

  • Skin biopsy
  • Immunofluorescence tests (fluorescent dye is used to highlight specific antigens within the blood)
  • Serology tests (specimens such as blood are taken and tested for antibodies)
  • Polymerase chain reaction (PCR) assay that tests blood, tissues, or plasma to determine the presence of the pathogen


The only way to treat all forms of typhus is antibiotics. The most commonly used antibiotics to treat bacterial infection are:

These antibiotics are designed to rid the body of the bacteria so that symptoms cease and the normal function of systems affected by the disease can return to their pre-typhus state.

Long-Term Effects of Typhus

When typhus remains untreated, it can lead to long-term health effects. Serious and lasting symptoms that can occur in an untreated typhus infection include:

  • Hearing loss
  • Low blood pressure
  • Organ failure
  • Pneumonia or other secondary bacterial infections
  • Seizures
  • Neurological decline such as confusion
  • Fatigue
  • Gangrene

For those who seek treatment promptly, typhus is generally resolved. However, there have been instances of the illness returning years after the initial infection took place. This condition is known as Brill-Zinsser disease.

When a bacteria is able to lay dormant within the body, it can be ‘missed’ by antibiotics only to reactivate later one. In the case of louse typhus and the onset of Brill-Zinsser disease, the symptoms are similar but milder than that of a typical case and will require treatment with antibiotics once again.


Although the risk isn’t that high, there are still things you can do to avoid contracting the illness. The most important step to avoiding a typhus infection is by staying away from rodents and wild animals, even the adorable cuddly ones.

Since the disease is spread through mites, lice, and fleas, keeping your distance from any animal that may be exposed to these types of things is the best bet in avoiding close contact with the infection. This can be done by keeping your house and land uninhabitable or less appealing to animals looking for a place to call home.

If you have pets, it’s pertinent to also keep them away from any other rodents or animals that may encourage the spread of fleas or mites (no matter how hard they may want to chase that squirrel).

A Word From Verywell

Typhus can be an intimidating disease, and when the symptoms are generally mild and mimic a cold or flu, it can be even more nerve-racking to think about. The important thing to remember when considering a typhus infection is your lifestyle and whether or not you’ve traveled to an area that has a high level of risk.

You can’t put your life on hold, but knowing the signs of the infection and the areas to be more aware of will help you to avoid the infection altogether, or provide you with the steps to take if you suspect you might have contracted the bacteria.

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Article Sources
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