What Is Louse-Borne Typhus (Epidemic Typhus)?

Reviewed on 12/14/2022
Louse-Borne Typhus
Louse-borne or epidemic typhus fever can lead to serious complications if left untreated.

Louse-borne or epidemic typhus fever is caused by the bacterium Rickettsia prowazekii.

In the United States, epidemic typhus is rare. It is more common in locations with poor hygiene and low temperatures. The bacterium that causes this variety of typhus is often transmitted from rats to fleas to humans.

The disease is usually seen in people exposed to flying squirrels or their nests and in people with poor hygiene practices or exposure to crowds.

What Are the Types of Typhus?

Depending on what has bitten a person, typhus is divided into three types:

  1. Louse-borne typhus or epidemic typhus: This is a rare type of typhus that infected body lice can spread. One type of epidemic typhus also spreads with exposure to flying squirrels, but it is considered very rare.
  2. Murine or endemic typhus: Fleas bite the infected animals, mainly rats, and then transmit murine typhus to humans. Most cases of murine typhus in the United States are seen in California, Hawaii, and Texas.
  3. Scrub typhus: The infected chiggers or the larval mites spread the disease. The disease is usually seen in the rural parts of Southeast Asia, China, Japan, India, and Northern Australia.

What Are the Signs and Symptoms of Typhus?

The symptoms appear 2 to 10 weeks after exposure to the bacteria. Different types of typhus show different signs and symptoms.

The following are the common symptoms of types of typhus:

Louse-borne or epidemic typhus

The following are the symptoms of louse-borne or epidemic typhus:

  • Confusion
  • Cough
  • Nausea
  • Vomiting
  • Sensitivity to light 

Murine or endemic typhus

The following are the symptoms of murine or endemic typhus:

Scrub typhus

The following are the symptoms of scrub typhus:

How to Diagnose Louse-borne or Epidemic Typhus

A healthcare provider does a general and physical examination and asks the following:

  • Symptoms
  • Socioeconomic status and living environment 
  • Any recent outbreak of typhus in the living areas 
  • Travel abroad

The diagnosis may become difficult because most of the symptoms are similar to those of malaria, dengue, and typhoid symptoms.

For proper diagnosis, the following diagnostic tests are recommended:

  • Skin biopsy
  • Blood tests
  • Western blot test to identify the bacteria
  • Immunofluorescence test to identify the typhus antigen in the serum taken from the bloodstream

How to Treat Typhus Infection

The effective way to treat all three types of typhus is by using an antibiotic called doxycycline. This antibiotic can be prescribed to any age group and should be given immediately after the symptoms start for effective results.

What Are the Complications of Typhus?

If the disease is left untreated, it results in serious, life-threatening complications.

The following are a few complications of typhus:

How to Prevent Typhus Infection

There is no specific vaccine to prevent the infection.

A few precautions may help control the transmission of the infection:

  • Maintain basic hygiene.
  • Stay away from animals or insects that spread the infection.
  • Do not leave food or any trash surrounding the house, which may attract the animals such as rats and flying squirrels, which are the major agents causing some types of typhus.

Louse-Borne Typhus Symptom and Sign


Rash is a general, nonspecific term that describes any visible skin outbreak. Rashes are very common in all ages, from infants to seniors, and nearly everyone will have some type of rash at some point in their life. There are a wide variety of medical diagnoses for skin rashes and many different causes. It is not possible to fully cover every type of rash in this type of article. Therefore, special mention has been given here to some of the most common types of rashes. A dermatologist is a medical provider who specializes in diseases of the skin and may need to be consulted for rashes that are difficult to diagnose and treat.

Reviewed on 12/14/2022
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