Why is Typhus making a comeback in the US? Risk factors and preventive tips

You’d think that with all our modern medicine, sanitation, pest control, and fancy hospitals, typhus would be something folks only read about in history books. But nope, it’s showing up again in states like Texas and California in ways that have public health folks raising red flags.

As per reports by NPR, Texas Public Radio, cases of the flea borne disease are rising.

What’s the situation now

Rising numbers: In Los Angeles County, cases of flea-borne typhus nearly tripled from ~31 in 2010 to ~171 in 2022, CNN says. Fatalities after decades: 2022 saw the first typhus‐related deaths in LA in about 30 years, three deaths in one year. Texas is heating up: Big uptick in “murine typhus” cases in Texas. From just a few hundred cases annually years ago to 800-plus in 2024, with the disease spreading into suburban/metro areas beyond traditional hotspots. Undetected & misdiagnosed: Many cases probably go unnoticed because symptoms (fever, headache, rash, fatigue) mimic flu, viral infections, or other common diseases. Folks don’t always think “typhus” when they or their doctor sees those signs.

Why is it coming back?

Here are the main culprits, the reasons experts believe murine/flea-borne typhus is creeping back in:Fleas, rodents, opossums, all key players in the typhus cycle, thrive in warmer, wetter conditions.

As winters become milder and summers hotter, the environment is more hospitable for these animals and pests.We’re seeing more interactions between humans, pets, and wildlife. Opossums and stray cats are common in many neighborhoods. Rodents are harder to keep out in some older or neglected housing. More people outdoors, gardening, living in places with rodent/animal exposure. All of this gives the fleas more chances.In some regions, pest control measures (rodent control, flea treatment on animals, sanitation) have weakened. Whether due to budget cuts, lack of awareness, or reduced vigilance, fewer preventive measures increases risk. Texas, for example, reports increasing numbers of cases across more counties.Because typhus had been rare for so long, many people (including healthcare providers) haven’t had reason to suspect it.

Misdiagnosis is common. If doctors don’t think of testing for typhus, cases go untreated or are treated too late. Plus, reporting isn’t uniform across all states, so the true scale is likely undercounted.Populations that are at greater risk often include people with lower access to clean housing, rodent control, flea-control for pets, and healthcare. Homelessness, neglected urban areas, or places with fewer resources become hotspots.

LA’s rising cases among homeless populations highlight this issue.

What’s at stake?

For most people, typhus isn’t fatal if caught early and treated (usually with antibiotics like doxycycline). But delays in diagnosis or untreated cases can lead to serious complications: organ involvement, severe illness, and, in rare instances, death. Also, beyond health, there’s a public health cost. It strains local health services.

What can people & public health officials do

Here are some smart moves being suggested to keep typhus from getting worse, and what you might want to know to protect yourself:Encourage doctors to think of typhus as a possible diagnosis for fevers + rash + animal/flea exposure.

Public education: what to look for, when to seek care.States that monitor and report these cases see the rises earlier. That helps with containment and treatment.Keeping rodents out of homes, maintaining yards, making sure pets have flea prevention, avoiding contact with stray animals.Improving housing, trash control, urban cleanliness so that rodent habitats are minimized.Typhus, especially the kind transmitted by fleas (“murine typhus” or “flea-borne typhus”), isn’t taking over the country.

But it is making a comeback in areas where conditions favor its spread, warm weather, stray/feral animals, weak pest control, and where people might not immediately connect symptoms to something so “old school.”It’s a reminder that diseases respond pretty quickly when preventive public health measures relax or when changing environments (climate, urban sprawl) give pathogens and vectors new opportunities.So yeah, old foes sometimes come back around. But with vigilance, better awareness, and some good flea and rodent control, this one can be kept under control.