A 75-year-old man from Kerala has been diagnosed with murine typhus, a rare bacterial disease transmitted by fleas, marking the first reported case of this infection in the state. The patient had recently returned from a trip to Vietnam and Cambodia, countries known for sporadic occurrences of the disease.

The man sought medical care at SP Medifort Hospital in Thiruvananthapuram on September 8 after experiencing body pain, fatigue, and appetite loss. His condition deteriorated with respiratory complications and subsequent kidney and liver dysfunction, necessitating ventilator support. Initial diagnostic tests were inconclusive, but based on his travel history and clinical presentation, doctors suspected murine typhus. Advanced diagnostic techniques, including Next Generation Sequencing (NGS), confirmed the presence of the bacterial infection.

What is Murine Typhus?

Murine typhus is caused by Rickettsia typhi, a bacterium transmitted primarily through the bites of infected fleas, such as the oriental rat flea (Xenopsylla cheopis). These fleas commonly infest rodents—including rats, mice, and mongooses—and may occasionally be found on domestic pets such as cats and dogs. Infected fleas remain carriers throughout their lifespan, increasing the likelihood of transmission. The disease, also known as flea-borne typhus or endemic typhus, can spread when humans come into contact with infected fleas or flea droppings.

Symptoms and Treatment

Individuals infected with murine typhus typically experience a range of symptoms, including:

• Fever and chills
• Muscle and body aches
• Abdominal pain
• Headache and cough
• Nausea and vomiting
• Rash (which usually develops around the fifth day of illness in some patients)

Although fatalities are rare, if left untreated, the disease can cause serious complications such as organ damage. Doxycycline, a widely-used antibiotic, is the recommended treatment and is effective across all age groups. Prompt treatment with antibiotics helps ensure quick recovery, though untreated cases can result in symptoms lasting up to two to three weeks.

Prevention Strategies

There is currently no vaccine available for murine typhus. The Centers for Disease Control and Prevention (CDC) recommends several preventive measures:

• Maintain proper flea control on pets by consulting a veterinarian for topical treatments or oral medications.
• Reduce rodent infestations by keeping food in sealed containers and eliminating clutter.
• Avoid contact with stray animals and use gloves when handling sick or deceased animals.

Also Read: India Hosts 19th International Conference of Drug Regulatory Authorities (ICDRA), Showcasing Global Leadership in Pharmaceutical Innovation

Global Spread and Impact

Murine typhus is reported in regions with tropical, subtropical, and temperate climates, including parts of Southeast Asia, Africa, Central and South America, Europe, and the Middle East. In India, sporadic cases have previously been identified in Madhya Pradesh, the Northeast, and Kashmir, but this is the first known case in Kerala.

The detection of murine typhus in Kerala highlights the importance of early diagnosis and prompt medical intervention in controlling rare infections. Healthcare providers are advised to consider travel history when diagnosing patients with unexplained symptoms, especially in regions where flea-borne infections are uncommon.

The case emphasizes the need for awareness about murine typhus among healthcare professionals and the public, particularly for travelers returning from areas where the disease is endemic.

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