Typhus and typhoid have both been in the news recently.
- Texas officials issue alert about typhus threat
- Typhoid: Two children die‚ 60 ill after drinking from contaminated stream in South Africa
Should you start panicking?
Of course not.

While neither is usually a threat to most people in developed countries, instead of panicking, get educated and learn how you can prevent these still common infections.
Typhus Fever
Epidemic typhus fever is spread by human body lice (not head lice!) that are infected with the Rickettsia prowazekii bacteria.
Symptoms of typhus fever can include the sudden onset of:
- fever
- muscle aches (myalgias)
- headache
- chills
- not feeling well (malaise)
- cough
Some patients develop a characteristic rash made up of small red spots (macules) that start on the upper trunk. It then spreads to the rest of the body, but spares the face, palms, and soles. The rash can eventually become petechial.
Untreated, the fever may last up to two weeks, followed by a slow recovery of two to three months for all of the other symptoms. Typhus fever can be fatal.
Fortunately, treatment is available – the antibiotic doxycycline.
How do you prevent epidemic typhus fever? You avoid body lice. And avoid flying squirrels, which can be infected with Rickettsia prowazekii bacteria.
Is typhus fever vaccine-preventable? No, although a typhus vaccine was once available, it was discontinued in 1979.
Keep in mind that in addition to epidemic typhus, which is now very rare, typhus can also be spread by fleas (murine typhus) and chiggers (scrub typhus).
Murine or endemic typhus is common in tropical and subtropical climates, where it is spread by rats and fleas. In the United States, it is mainly found in California, Hawaii, and Texas, where it has also been associated with cat fleas found on cats and opossums.
Scrub typhus is associated with chiggers in rural areas of Southeast Asia, Indonesia, China, Japan, India, and northern Australia.
Typhoid Fever
Although typhus and typhoid some very similar, there are some big differences between these two diseases.
What are they?
Unlike typhus, typhoid fever is:
- caused by the Salmonella typhi bacteria
- spread by ingesting contaminated food and water
- characteristic by symptoms that include a gradual onset of fever, with stomach aches, headache, loss of appetite, and sometimes a rash.
- still vaccine preventable – in fact, there are two typhoid vaccine, one oral and the other a shot
Fortunately, typhoid fever can be treated with antibiotics, although it is sometimes multi-drug resistant and some people become chronic carriers, even with treatment (Typhoid Mary).

That it can still be treated is a good thing, because unlike epidemic typhus, typhoid fever is still very much around.
The CDC estimates that there are about 5,700 cases of typhoid fever in the United States each year, mostly in travelers that leave the country.
Worldwide, there are about 21 million cases of typhoid fever and 222,000 typhoid-related deaths each year!
In addition to getting vaccinated, if traveling to the developing world, to avoid typhoid, you should avoid risky food and be sure to “Boil it, cook it, peel it, or forget it.”
What to Know About Typhus and Typhoid Fever
Typhus and typhoid fevers are two very different diseases that can both be avoided with good hygiene practices.
More on Typhus and Typhoid Fever
- Texas officials issue alert about typhus threat
- Typhoid: Two children die‚ 60 ill after drinking from contaminated stream
- WHO – Typhus fever (Epidemic louse-borne typhus)
- CDC – Typhus fevers
- Rickettsia prowazekii infections
- Typhus, War, and Vaccines
- WHO – Typhoid fever
- CDC – Typhoid Fever
- The Curious Career of Typhoid Mary
- Avoid High-Risk Foods