Transmitted via flea bites. Infective fleas defecate rickettsiae while taking a blood meal, which contaminates the bite site and other fresh skin wounds.

Incubation period: Typically 12 days; range is 1 to 2 weeks.

Infectious period: There is no human-to-human transmission.

Clinical features

Murine typhus is generally a mild infection. Symptoms include:

Fever
Headache
Myalgia

Rash occurs in majority of patients although it is usually not present at onset of illness.

Other symptoms reported include abdominal pain, nausea, and vomiting.

The disease is usually recognised when clinicians correlate the presence of compatible clinical signs, symptoms, and laboratory features, with epidemiologic clues.

Risk factors

Risk factors include:

Exposure to fleas.

Diagnosis

Serological tests are most frequently used in the laboratory diagnosis of murine typhus.

Treatment and management

In mild cases, oral antibiotics can be given. Severe cases will require hospitalisation for intravenous antibiotics and management of complications.

Precaution, prevention, and control

Standard precautions apply in healthcare settings.

There is no available vaccine. Preventive measures include impregnating clothes with miticidal chemicals (e.g. permethrin) and application of mite repellent (e.g. containing more than 20% DEET) on skin.

Anti-flea and rodent control measures should be implemented.

Notification

Who should notify:

Laboratories

When to notify:

On laboratory confirmation

How to notify:

Please refer to the Infectious Disease Notification for more information.

Notification timeline:

As soon as possible. No later than 24 hours from the time of diagnosis.

Resources

Please refer to the Weekly Infectious Diseases Bulletin for the number of murine typhus cases in Singapore.