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Overseas information: www.cdc.gov/ncidod/diseases/Index.htm

Typhus: (Murine typhus; Brill-Zinsser disease)

An infectious rickettsial disease transmitted by the human louse or a flea and characterized by fever, a transient rash, and falling blood pressure. It is usually associated with poor personal hygiene.

It occurs in remote areas of countries in north, central and southern Africa, Mexico, central and southern America, middle and western areas of Asia. The incubation period is 10 - 14 days.
Typhus is caused by one of two organisms, R. prowazekii (epidemic typhus and Brill disease) and R. typhi (Murine typhus)
Murine typhus is a milder form of typhus and is seldom fatal (less than 2%). It is frequently seen in the summer and fall. The course of Murine typhus lasts two to three weeks.

SYMPTOMS
MURINE TYPHUS

• headache, backache and arthralgia
• fever, extremely high (105 to 106 degrees Fahrenheit) and may last up to two weeks
• rash that begins on the trunk and spreads peripherally (The rash is made up of dull red macules that may become slightly papular after the initial appearance may last only a few hours.)

EPIDEMIC TYPHUS

• headache, arthralgia and myalgia
• fever, high (104 degrees Fahrenheit) chills
• falling blood pressure
• stupor delirium
• rash that begins on chest and spreads to rest of trunk and extremities
• The early rash is faint and rose colored and fades with pressure. Later the lesions become dull red and do not fade. People with severe typhus may also develop petechiae.

TREATMENT
The goal of treatment is to eliminate the infection and to treat the symptoms with antibiotics such as tetracycline, doxycycline, or chloramphenicol. For epidemic typhus, intravenous fluids and oxygen may be necessary.
With timely antibiotic therapy, the affected person is expected to recover completely.

Information mostly taken from: "International Travel and Health" (WHO year book - internet only)
Australian Immunisation Handbook, 8th Edition - 9/2003 - Part1 - Part 2 & Part 3 (large pdf files)
Centre for Disease Control, USA -  www.cdc.gov/travel Travel Health Seminar Oct 96, June 97,Feb 98, March 99, May 2000, August 2002 & March 2005 - Victorian Medical Postgraduate Foundation.
Manual of Travel Medicine, Melbourne, Oct 2004. Updated 18/09/2005.  Additional references & disclaimer.

  Last Update: 14-Sep-2005