A potentially deadly disease once thought to be wiped out in the United States is rearing its ugly head again: epidemic typhus has been reported in overcrowded, poverty-stricken neighborhoods in Los Angeles, California and elsewhere in the nation.
Epidemic typhus, caused by the bacteria Rickettsia prowazekii, is much more serious than endemic typhus (Rickettsia typhi). The unpleasant symptoms for both infections include bodily rash, high fever, nausea, vomiting, discomfort, and diarrhea. With epidemic typhus, the symptoms are much more severe.
In days past, body lice infected with epidemic typhus spread the deadly disease to people whose hygiene levels were lower than those of modern society. Epidemic typhus has been the cause for millions of deaths in prior centuries. There is no vaccine available to protect against this virulent disease.
Typhus thrives in places with large numbers of rats, mice, and other lice-inflicted animals. Squalid, overcrowded conditions promote the rise of vermin and the lice they carry. Jails, disaster areas, and slums are also places likely to see outbreaks of epidemic typhus.
Typhus is not transmitted person-by-person and it does not infect pets and other animals.
In the past, before the dangers of DDT (the potent WWII insecticide) became known through Rachel Carson’s 1962 best-seller Silent Spring, school children were actually dusted with the toxic chemical to get rid of head lice.
Typhus can only spread conditions of extreme overcrowding where body lice can move from one person to another. Symptoms appear within two weeks of infection by body lice and include fever and chills, headache, rapid breathing, body and muscle aches, rash, cough, nausea, vomiting, and confusion.
Officials from the Los Angeles (L.A.) County Department of Public Health have declared an “outbreak” of epidemic typhus that has reached “epidemic levels” in the Los Angeles area.
As of early October, California’s Pasadena (northeast of L.A.) reported 20 cases and Long Beach (southern L.A.) identified 12 cases. There would be perhaps five cases reported in a normal year. The county website explained how the disease takes hold in the human body:
“Infection happens when the feces from infected fleas are rubbed into cuts or scrapes in the skin or rubbed into the eyes.”
Pasadena health officer Ying-Ying Goh, M.D., explained that treating typhus is expensive:
“Typhus fever is a disease that can cause serious complications requiring lengthy hospitalization, and rarely, death.”
Because the affliction is spread by lice, winter may not slow down its spread, unlike cold-sensitive bacteria.
The Los Angeles Public Health Department identified high-risk areas for epidemic typhoid outbreaks:
“Places where there is an accumulation of trash that attract wild animals like feral cats, rats and opossums that may carry an infected flea may increase the risk of exposure.”
This writer previously covered the unsanitary conditions existing today in San Francisco, north of L.A. Evidently, urban crowding and the rise of tent cities is responsible for the typhus outbreak raging across California.
Aaron Glatt, MD, chairman of medicine and hospital epidemiologist for South Nassau Communities Hospital, Oceanside, NY, said that “homelessness, crowded housing, poor hygiene, [and] poor toiletry habits” contribute to the rise of typhus.
As of November 2018, L.A. health officials have pegged the number of epidemic typhus cases at 107.
Typhus is also breaking out in Texas, and it is also on the rise. Houston and Galveston are leading the state in the number of reported cases:
“The Texas health department reports there were 519 cases of typhus in 2017, more than three times the number in 2010. The uptick represents the fourth consecutive year that the number has increased. Harris County recorded 71 of the cases last year, up from 32 cases in 2016. Galveston County has already reported more cases in 2018, 18, than in all of last year.”
Epidemic typhus is a health problem that, in the long run, is best solved economically, by providing jobs and sanitary housing to homeless street people and slum dwellers. This is a daunting task but not impossible.
Years of urban blight and economic downturn are now taking their toll, manifesting as a rampant pestilence. Is epidemic typhus the tip of the iceberg? Will other deadly diseases, thought to be all but extinct, resurface in places with substandard living conditions?
Let’s not wait to find out, shall we? Instead, we can work together to find effective and realistic solutions to this medical crisis that spring from overcrowding and dirty slums.