Endemic typhus fever is a rickettsial disease within the typhus group, caused by the obligate intracellular Gram-negative bacterium Rickettsia typhi [1][2]. It is maintained in nature through cycles involving mammalian hosts and flea vectors, with humans infected incidentally via arthropod bites [2].
Disease overview
Bacterial Evidence-backed information EN 5/7 applicable sections · ZH 5/7 applicable sections Updated Oct 23, 2026
Typhus, also known as typhus fever, is a group of infectious diseases that include epidemic typhus, scrub typhus, and murine typhus [1]. The diseases are caused by specific types of bacterial infection [1], with common symptoms such as fever, headache, and a rash typically beginning one to two weeks after exposure [1][2].
Read the full clinical and epidemiological profile 6
The illness commonly presents with fever, headache, and rash, with symptoms typically appearing one to two weeks after exposure [1].
Epidemic typhus generally occurs in outbreaks when poor sanitary conditions and crowding are present and, while once common, it is now rare [1]. Scrub typhus occurs in Southeast Asia, Japan, and northern Australia [1], and murine typhus occurs in tropical and subtropical areas of the world [1]. In 2018 a murine typhus outbreak spread through Los Angeles County, primarily affecting homeless people [1], and over the past decade murine typhus cases have been rising with the highest number of cases being 171 in 2022 [1]. In Spain the most prevalent rickettsioses include murine typhus caused by R. typhi .
The causative agent Rickettsia typhi is spread by fleas, and humans acquire infection through flea bites [1][2]. Exposure can be reduced by controlling fleas on pets, avoiding wild animals, using insect repellent, and preventing rodent entry into homes [1].
Recommended measures include treating pets for fleas, avoiding sick or dead animals with glove use, applying insect repellent, and excluding rodents and wildlife from living spaces [1].
- 1 Wikipedia contributors. Typhus - Wikipedia [Internet]. Wikipedia. cited 12 Aug 2026. Available from: https://en.wikipedia.org/wiki/Typhus
- 2 Bernabeu-Wittel M et al. [Rickettsioses]. Enferm Infecc Microbiol Clin. 2005 Mar. PMID: 15757589. doi: 10.1157/13072167. PubMed: https://pubmed.ncbi.nlm.nih.gov/15757589/
- 3 Matos AL et al. Moonlighting in Rickettsiales: Expanding Virulence Landscape. Trop Med Infect Dis. 2022 Feb 19. PMID: 35202227. doi: 10.3390/tropicalmed7020032. PubMed: https://pubmed.ncbi.nlm.nih.gov/35202227/
- A75.2
- 1C30
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