Also known as typhus fever, is a group of infectious diseases that include epidemic typhus, scrub typhus and murine typhus.

Common symptoms include sudden fever, headache, rash. and other flu-like symptoms, about one to two weeks after being infected.

Signs and symptoms begin with sudden onset of fever, and other flu-like symptoms about one to two weeks after being infected.

Five to nine days after the symptoms begin, a rash typically begins on the trunk and spreads to the extremities.

This rash eventually spreads over most of the body, but spares the face, palms, and soles.

Symptoms typically these begin one to two weeks after exposure.

Fever, headache, rash usually appear 1–2 weeks after exposure.

Meningoencephalitis begins with the rash and continue into the second or third weeks.

Signs of meningoencephalitis include photophobia, altered mental status, or coma.

Untreated cases of meningoencephalitis are often fatal.

Current death rate from typhus is about one out of every 5,000,000 people per year.

Only a few areas of epidemic typhus exist today.

An outbreak of flea-borne typhus was identified in downtown Los Angeles, California in October, 2018.

It is a rare bacterial infection spread by parasites.

Epidemic typhus is due to Rickettsia prowazekii spread by body lice.

Scrub typhus is due to Orientia tsutsugamushi spread by chiggers.

Murine typhus is due to Rickettsia typhi spread by fleas.

There is currently no commercially available vaccine.

Prevention goal is to reduce exposure to the organisms that spread the disease.

Treatment is with the doxycycline.

Epidemic typhus generally occurs in outbreaks when poor sanitary conditions and crowding prevail.

Scrub typhus occurs in Southeast Asia, Japan, and northern Australia.

Murine typhus occurs in tropical and subtropical areas of the world.

Presently there is no commercially available vaccine

There is a vaccine has been in development for scrub typhus known as the scrub typhus vaccine.

Treatment should be instituted based upon clinical findings and before culturing confirms the diagnosis.

Without treatment, death may occur in 10 to 60 percent of patients with epidemic typhus.

The death rate in patients over age 60 having the highest risk.

Treatment with doxycycline prevents death.

Supportive care may be necessary.

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