Flea-borne typhus is not usually deadly in the United States – the mortality rate is less than 2%. But Dr. Gregory Anstead says it’s a disease that can cause a lot of problems.
“It can cause very serious manifestations in the brain and the heart, in the liver, in the kidneys, in the lungs. It can cause septic shock. And about one-third of those that are affected end up in the ICU for some period of time,” Anstead said.
Anstead is a professor in the Division of Infectious Diseases at UT Health Science Center at San Antonio and a staff physician at the Audie Murphy VA hospital.
“We had a case in San Antonio where a 16-year-old girl got this disease. She went into septic shock. She ended up losing parts of three limbs from the septic shock,” Anstead said. “So it can be very, very serious.”
And it can start with a flea bite.
“Or someone scratching flea feces into the bite or rubbing their eyes if they’ve been contaminated by flea feces after petting a pet,” Anstead said.
This has been happening more in Texas in recent decades. Anstead wrote about the numbers and the reasons this might be happening for the journal Pathogens.
He writes that flea-borne typhus was high in Texas in the 1940s but declined in the following decades because of a “massive public health program” for rat extermination and spraying for fleas.
The Texas Department of State Health Services began to see an increase in cases again in the year 2000.
“I’ve reexamined the data and found that the number of cases went from 307 in the decade of the 1990s up to 3,750 in the decade of 2010 to 2019. So that’s basically a 12-fold rise in the state of Texas,” Anstead said.
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He says the disease has traditionally been more isolated to South Texas but now has also been found further north – including in Bexar, Travis, Harris, Dallas and Tarrant counties. Anstead believes population growth is part of the influx.
“The state of Texas, of course, has had an explosive population growth in the 30 years since the 1990s,” Anstead said. “And so when people come into an area, they bring their pet dogs and cats. And so that’s more hosts for the flea.”
He says another factor is warmer temperatures due to climate change and the urban heat island effect.
“Fleas are more likely to have more vigorous biting of pets when they’re hotter; they have more mating when they’re warmer,” Anstead said. “And then the other thing is that the warmer temperature also accelerates the growth of the bacteria inside the flea.”
Unlike measles, there is not an effective vaccine to prevent flea-borne typhus. So Anstead says the best action is avoiding flea infestations in the first place.
“People who have had cats and dogs should not take this lightly that they need to provide year-long protection for their pets, which also protects them,” Anstead said.
He also points out that stray animals should be controlled through trap, neuter, release programs. And he suggests some insecticide spraying might be necessary in areas highly contaminated by fleas.
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