PRO/AH/EDR> Murine typhus – USA (02): (TX) sepsis, multiorgan failure, limb gangrene


A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases

Date: Fri 21 Jul 2023
Source: USA TODAY [abridged, edited]

A single flea bite has caused a Texas man to lose several limbs over
the past month. There are more than 2500 different flea species found
around the world, but only 4 are known to severely affect your health,
according to the Centers for Disease Control and Prevention. Of those
2500 flea species, only about 300 are found in the U.S.

[The 35-year-old man], was admitted to the hospital with what he
thought was the flu, according to the family’s GoFundMe post. As the
day progressed, he was transferred to the intensive care unit as his
body became septic. [The patient] was put on a ventilator, treated
with a number of antibiotics, and entered dialysis as doctors spent
the next 24 hours trying to determine a diagnosis. By the end of 20
Jun 2023, his family was informed they needed to say their goodbyes.
[The patient] woke up out of his haze about a week and a half later.

Doctors told the family the reason he experienced sepsis was because
he had contracted typhus. The flea bite had also caused tissue death
in both his hands and feet. Both of his hands have been amputated up
to his forearms and doctors are still trying to assess what parts of
his feet can be saved. As he undergoes a number of surgeries to get
him back on the road to recovery, his family set up the GoFundMe to
cover the cost of medical treatment.

Some fleas carry [bacteria] that can cause human diseases like the
plague, flea-borne (murine) typhus, cat scratch disease (CSD), and
flea-borne parasites like tapeworms

The typhus [the patient] contracted came from a flea, his family told
KSLA12News. [He] did not develop swelling or a rash where the flea bit
him, which could have potentially allowed doctors to treat the disease
earlier, KSLA12News reported. Murine typhus is transmitted to people
by infected animals like rats, cats, or opossums. The bite generally
breaks the skin, causing a wound. Since fleas poop while they feed,
the poop can be rubbed into the wound or any other wound. People can
also contract murine typhus if they breathe in infected flea poop or
rub it in their eyes, according to the CDC.

Symptoms generally begin within 2 weeks after initial contact. The
most common symptoms include a fever and chills; body aches and muscle
pains; loss of appetite; nausea and vomiting; and a rash. Murine
typhus is normally treated with an antibiotic known as doxycycline.
People who are treated right after symptoms begin usually recover

The disease does not spread from person to person. Murine typhus cases
are more common in tropical and subtropical climates. California,
Texas, and Hawaii have reported cases to the CDC, but the disease is
not typically seen in the US.

One of the easiest ways to keep you and your family safe from fleas is
to keep your pets flea-free. Flea species in the US tend to feed on
animals, but sometimes people are bitten when they share space or come
into contact with a flea-infested animal, according to the CDC. Here
are some tips from the CDC to keep you safe:
– Use Environmental Protection Agency (EPA)-registered insect
repellents containing DEET, picaridin, IR3535, oil of lemon eucalyptus
(OLE), para-menthane-diol (PMD), or 2-undecanone. the EPA’s helpful
search tool can help you find the product that best suits your needs.
Always follow product instructions. Do not use products containing OLE
or PMD on children under 3 years old.
– Cover skin with long-sleeve clothing and pants to minimize exposure
to bites. Flea bites often occur on the lower legs and feet. Protect
these areas with long socks and pants.
– Treat clothing and gear with products containing 0.5% permethrin.
Permethrin can be used to treat boots, clothing, and camping gear and
remain protective through several washings. Alternatively, you can buy
permethrin-treated clothing and gear.
– Do not feed or pet stray or wild animals.
– Always wear gloves if you are handling sick or dead animals.

[Byline: Amaris Encinas]

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