{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T15:04:01Z","timestamp":1790089441942,"version":"4.0.1"},"reference-count":45,"publisher":"Centers for Disease Control and Prevention (CDC)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Emerg. Infect. Dis."],"published-print":{"date-parts":[[2026,6]]},"DOI":"10.3201\/eid3206.251015","type":"journal-article","created":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T16:41:44Z","timestamp":1779813704000},"source":"Crossref","is-referenced-by-count":1,"title":["Outcomes of Hospitalized and Critically Ill Adults with Murine Typhus, Galveston, Texas, USA, 2019\u20132023"],"prefix":"10.3201","volume":"32","author":[{"given":"Matthew","family":"Pickich","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Puneet","family":"Singh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Efstathia","family":"Polychronopoulou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shawn P.","family":"Nishi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas S.","family":"Blanton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander G.","family":"Duarte","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1822","reference":[{"key":"key-10.3201\/eid3206.251015-202605261241-R1","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1016\/j.idc.2018.10.010","article-title":"The rickettsioses: a practical update.","volume":"33","author":"Blanton","year":"2019","journal-title":"Infect Dis Clin North Am"},{"key":"key-10.3201\/eid3206.251015-202605261241-R2","doi-asserted-by":"publisher","first-page":"2173","DOI":"10.1001\/jama.1986.03370160071029","article-title":"Epidemiology of murine typhus in Texas. 1980 through 1984.","volume":"255","author":"Taylor","year":"1986","journal-title":"JAMA"},{"key":"key-10.3201\/eid3206.251015-202605261241-R3","doi-asserted-by":"publisher","first-page":"1613","DOI":"10.3201\/eid1410.080571","article-title":"Rickettsia typhi and R. felis in rat fleas (Xenopsylla cheopis), Oahu, Hawaii.","volume":"14","author":"Eremeeva","year":"2008","journal-title":"Emerg Infect Dis"},{"key":"key-10.3201\/eid3206.251015-202605261241-R4","doi-asserted-by":"publisher","first-page":"e0160604","DOI":"10.1371\/journal.pone.0160604","article-title":"Rickettsial infections among Ctenocephalides felis and host animals during a flea-borne rickettsioses outbreak in Orange County, California.","volume":"11","author":"Maina","year":"2016","journal-title":"PLoS One"},{"key":"key-10.3201\/eid3206.251015-202605261241-R5","doi-asserted-by":"publisher","first-page":"1044","DOI":"10.3201\/eid2605.191505","article-title":"Rise in murine typhus in Galveston County, Texas, USA, 2018.","volume":"26","author":"Ruiz","year":"2020","journal-title":"Emerg Infect Dis"},{"key":"key-10.3201\/eid3206.251015-202605261241-R6","doi-asserted-by":"publisher","first-page":"516","DOI":"10.1111\/j.1749-6632.1958.tb35408.x","article-title":"The changing picture of murine typhus in the United States.","volume":"70","author":"Pratt","year":"1958","journal-title":"Ann N Y Acad Sci"},{"key":"key-10.3201\/eid3206.251015-202605261241-R7","doi-asserted-by":"publisher","first-page":"1","DOI":"10.52707\/1081-1710-50.1-1","article-title":"Murine typhus: a re-emerging rickettsial zoonotic disease.","volume":"50","author":"Snellgrove","year":"2024","journal-title":"J Vector Ecol"},{"key":"key-10.3201\/eid3206.251015-202605261241-R8","doi-asserted-by":"publisher","first-page":"1365","DOI":"10.1001\/jama.1991.03470100057033","article-title":"Clinical and laboratory features of murine typhus in south Texas, 1980 through 1987.","volume":"266","author":"Dumler","year":"1991","journal-title":"JAMA"},{"key":"key-10.3201\/eid3206.251015-202605261241-R9","doi-asserted-by":"publisher","first-page":"700","DOI":"10.3390\/idr15060063","article-title":"Murine typhus: a review of a reemerging flea-borne rickettsiosis with potential for neurologic manifestations and sequalae.","volume":"15","author":"Blanton","year":"2023","journal-title":"Infect Dis Rep"},{"key":"key-10.3201\/eid3206.251015-202605261241-R10","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1016\/j.jccase.2021.02.007","article-title":"Fulminant myocarditis secondary to murine typhus mimicking acute coronary syndrome.","volume":"24","author":"Toy","year":"2021","journal-title":"J Cardiol Cases"},{"key":"key-10.3201\/eid3206.251015-202605261241-R11","doi-asserted-by":"publisher","first-page":"1375","DOI":"10.3201\/eid2008.131421","article-title":"Severe murine typhus with pulmonary system involvement.","volume":"20","author":"van der Vaart","year":"2014","journal-title":"Emerg Infect Dis"},{"key":"key-10.3201\/eid3206.251015-202605261241-R12","doi-asserted-by":"publisher","first-page":"e00645","DOI":"10.1016\/j.idcr.2019.e00645","article-title":"Rickettsia typhi infection presenting as severe ARDS.","volume":"18","author":"Tran","year":"2019","journal-title":"IDCases"},{"key":"key-10.3201\/eid3206.251015-202605261241-R13","doi-asserted-by":"publisher","first-page":"838","DOI":"10.15585\/mmwr.mm7231a1","article-title":"Fleaborne typhus\u2013associated deaths\u2014Los Angeles County, California, 2022.","volume":"72","author":"Alarc\u00f3n","year":"2023","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"key-10.3201\/eid3206.251015-202605261241-R14","doi-asserted-by":"publisher","first-page":"e0008641","DOI":"10.1371\/journal.pntd.0008641","article-title":"A systematic review of the untreated mortality of murine typhus.","volume":"14","author":"Doppler","year":"2020","journal-title":"PLoS Negl Trop Dis"},{"key":"key-10.3201\/eid3206.251015-202605261241-R15","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1016\/j.actatropica.2016.10.018","article-title":"Clinical and laboratory characteristics, epidemiology, and outcomes of murine typhus: a systematic review.","volume":"166","author":"Tsioutis","year":"2017","journal-title":"Acta Trop"},{"key":"key-10.3201\/eid3206.251015-202605261241-R16","doi-asserted-by":"publisher","first-page":"433","DOI":"10.1097\/QCO.0000000000000298","article-title":"State of the art of diagnosis of rickettsial diseases: the use of blood specimens for diagnosis of scrub typhus, spotted fever group rickettsiosis, and murine typhus.","volume":"29","author":"Paris","year":"2016","journal-title":"Curr Opin Infect Dis"},{"key":"key-10.3201\/eid3206.251015-202605261241-R17","doi-asserted-by":"crossref","first-page":"1487","DOI":"10.1016\/j.amjmed.2025.06.005","article-title":"Murine typhus\u2014a horse in zebra\u2019s clothing.","volume":"138","author":"Blanton","year":"2025","journal-title":"Am J Med"},{"key":"key-10.3201\/eid3206.251015-202605261241-R18","unstructured":"Texas Department of State Health Services. Epi case criteria guide 2022 [cited 2021 Nov 1]. https:\/\/www.dshs.state.tx.us\/sites\/default\/files\/IDCU\/investigation\/epi-case-criteria-guide\/2022-Epi-Case-Criteria-Guide.pdf"},{"key":"key-10.3201\/eid3206.251015-202605261241-R19","unstructured":"Centers for Disease Control and Prevention. Clinical overview of flea-borne typhus [cited 2021 Apr 18]. https:\/\/www.cdc.gov\/typhus\/hcp\/clinical-overview\/clinical-overview-of-murine-typhus.html"},{"key":"key-10.3201\/eid3206.251015-202605261241-R20","doi-asserted-by":"publisher","first-page":"727","DOI":"10.1093\/jac\/38.4.727","article-title":"The in-vitro anti-rickettsial activity of macrolides.","volume":"38","author":"Keysary","year":"1996","journal-title":"J Antimicrob Chemother"},{"key":"key-10.3201\/eid3206.251015-202605261241-R21","doi-asserted-by":"publisher","first-page":"738","DOI":"10.1093\/cid\/ciy563","article-title":"A prospective, open-label, randomized trial of doxycycline versus azithromycin for the treatment of uncomplicated murine typhus.","volume":"68","author":"Newton","year":"2019","journal-title":"Clin Infect Dis"},{"key":"key-10.3201\/eid3206.251015-202605261241-R22","doi-asserted-by":"crossref","unstructured":"Dumler JS. Clinical disease: current treatment and new challenges. In: Palmer GH, Azad AF, editors. Intracellular pathogens II: rickettsiales. Washington: ASM Press; 2012. p. 1\u201339.","DOI":"10.1128\/9781555817336.ch1"},{"key":"key-10.3201\/eid3206.251015-202605261241-R23","doi-asserted-by":"publisher","first-page":"17","DOI":"10.7326\/0003-4819-23-4-520","article-title":"Endemic (murine) typhus fever: clinical observations of 180 cases.","volume":"23","author":"Stuart","year":"1945","journal-title":"Ann Intern Med"},{"key":"key-10.3201\/eid3206.251015-202605261241-R24","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1097\/00005792-194602000-00001","article-title":"Murine typhus fever.","volume":"25","author":"Miller","year":"1946","journal-title":"Medicine (Baltimore)"},{"key":"key-10.3201\/eid3206.251015-202605261241-R25","doi-asserted-by":"publisher","first-page":"412","DOI":"10.3201\/eid1603.091028","article-title":"Murine typhus in Austin, Texas, USA, 2008.","volume":"16","author":"Adjemian","year":"2010","journal-title":"Emerg Infect Dis"},{"key":"key-10.3201\/eid3206.251015-202605261241-R26","doi-asserted-by":"publisher","first-page":"1268","DOI":"10.3201\/eid2308.161861","article-title":"Acute febrile illness and complications due to murine typhus, Texas, USA.","volume":"23","author":"Afzal","year":"2017","journal-title":"Emerg Infect Dis"},{"key":"key-10.3201\/eid3206.251015-202605261241-R27","doi-asserted-by":"publisher","first-page":"1088","DOI":"10.4269\/ajtmh.16-0465","article-title":"Fatal flea-borne typhus in Texas: a retrospective case series, 1985\u20132015.","volume":"96","author":"Pieracci","year":"2017","journal-title":"Am J Trop Med Hyg"},{"key":"key-10.3201\/eid3206.251015-202605261241-R28","doi-asserted-by":"publisher","first-page":"86","DOI":"10.2344\/0003-3006-56.3.86","article-title":"Perioperative management of the glucose-6-phosphate dehydrogenase deficient patient: a review of literature.","volume":"56","author":"Elyassi","year":"2009","journal-title":"Anesth Prog"},{"key":"key-10.3201\/eid3206.251015-202605261241-R29","doi-asserted-by":"publisher","first-page":"1017","DOI":"10.4269\/ajtmh.20-0116","article-title":"Case report: renal failure due to focal segmental glomerulosclerosis in a patient with murine typhus.","volume":"103","author":"Blanton","year":"2020","journal-title":"Am J Trop Med Hyg"},{"key":"key-10.3201\/eid3206.251015-202605261241-R30","doi-asserted-by":"publisher","first-page":"132","DOI":"10.3390\/idr15010014","article-title":"Flea-borne typhus causing hemophagocytic lymphohistiocytosis: an autopsy case.","volume":"15","author":"Chandramohan","year":"2023","journal-title":"Infect Dis Rep"},{"key":"key-10.3201\/eid3206.251015-202605261241-R31","doi-asserted-by":"publisher","first-page":"1425","DOI":"10.1586\/eri.12.139","article-title":"Treatment of Rickettsia spp. infections: a review.","volume":"10","author":"Botelho-Nevers","year":"2012","journal-title":"Expert Rev Anti Infect Ther"},{"key":"key-10.3201\/eid3206.251015-202605261241-R32","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1146\/annurev-pathmechdis-012418-012800","article-title":"Pathogenesis of rickettsial diseases: pathogenic and immune mechanisms of an endotheliotropic infection.","volume":"14","author":"Sahni","year":"2019","journal-title":"Annu Rev Pathol"},{"key":"key-10.3201\/eid3206.251015-202605261241-R33","doi-asserted-by":"crossref","unstructured":"Blanton LS, Walker DH, Bouyer DH.\n                      Rickettsia\n                      and\n                      Orientia.\n                      In: Carroll KC, Pfaller MA, Landry ML, McAdam AJ, Patel R, editors. Manual of clinical microbiology. 12th ed. Washington: ASM Press; 2019. p. 1149\u20131162.","DOI":"10.1128\/9781683670438.MCM.ch66"},{"key":"key-10.3201\/eid3206.251015-202605261241-R34","doi-asserted-by":"publisher","first-page":"1","DOI":"10.4269\/ajtmh.23-0742","article-title":"Rickettsia typhi in southern California: a growing flea-borne threat.","volume":"110","author":"Blanton","year":"2023","journal-title":"Am J Trop Med Hyg"},{"key":"key-10.3201\/eid3206.251015-202605261241-R35","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1038\/nrmicro1866","article-title":"Emerging and re-emerging rickettsioses: endothelial cell infection and early disease events.","volume":"6","author":"Walker","year":"2008","journal-title":"Nat Rev Microbiol"},{"key":"key-10.3201\/eid3206.251015-202605261241-R36","doi-asserted-by":"publisher","first-page":"404","DOI":"10.1016\/j.cmi.2015.04.022","article-title":"Neglected bacterial zoonoses.","volume":"21","author":"Chikeka","year":"2015","journal-title":"Clin Microbiol Infect"},{"key":"key-10.3201\/eid3206.251015-202605261241-R37","doi-asserted-by":"publisher","first-page":"720","DOI":"10.1093\/ajcp\/91.6.720","article-title":"Histopathology and immunohistologic demonstration of the distribution of Rickettsia typhi in fatal murine typhus.","volume":"91","author":"Walker","year":"1989","journal-title":"Am J Clin Pathol"},{"key":"key-10.3201\/eid3206.251015-202605261241-R38","doi-asserted-by":"publisher","first-page":"860","DOI":"10.1097\/CCM.0000000000005361","article-title":"Consensus-based guidelines for the recognition, diagnosis, and management of hemophagocytic lymphohistiocytosis in critically ill children and adults.","volume":"50","author":"Hines","year":"2022","journal-title":"Crit Care Med"},{"key":"key-10.3201\/eid3206.251015-202605261241-R39","doi-asserted-by":"publisher","first-page":"1049","DOI":"10.4269\/ajtmh.2012.11-0794","article-title":"Murine typhus in returned travelers: a report of thirty-two cases.","volume":"86","author":"Walter","year":"2012","journal-title":"Am J Trop Med Hyg"},{"key":"key-10.3201\/eid3206.251015-202605261241-R40","doi-asserted-by":"publisher","first-page":"713","DOI":"10.1016\/j.revmed.2022.08.005","article-title":"[Parvovirus B19 infections in adults]","volume":"43","author":"Jacquot","year":"2022","journal-title":"Rev Med Interne"},{"key":"key-10.3201\/eid3206.251015-202605261241-R41","doi-asserted-by":"publisher","first-page":"e01955","DOI":"10.1016\/j.idcr.2024.e01955","article-title":"Severe flea-borne typhus complicated by hemophagocytic lymphohistiocytosis: a case report and review of literature.","volume":"36","author":"Zamora Gonzalez","year":"2024","journal-title":"IDCases"},{"key":"key-10.3201\/eid3206.251015-202605261241-R42","doi-asserted-by":"publisher","first-page":"484","DOI":"10.3201\/eid2103.140716","article-title":"Reemergence of murine typhus in Galveston, Texas, USA, 2013.","volume":"21","author":"Blanton","year":"2015","journal-title":"Emerg Infect Dis"},{"key":"key-10.3201\/eid3206.251015-202605261241-R43","doi-asserted-by":"publisher","first-page":"212","DOI":"10.3201\/eid2901.221206","article-title":"Increased seroprevalence of typhus group rickettsiosis, Galveston County, Texas, USA.","volume":"29","author":"Blanton","year":"2023","journal-title":"Emerg Infect Dis"},{"key":"key-10.3201\/eid3206.251015-202605261241-R44","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1111\/j.1574-6968.1991.tb04783.x","article-title":"Antigenic relationships among the rickettsiae of the spotted fever and typhus groups.","volume":"65","author":"Vishwanath","year":"1991","journal-title":"FEMS Microbiol Lett"},{"key":"key-10.3201\/eid3206.251015-202605261241-R45","doi-asserted-by":"publisher","first-page":"1594","DOI":"10.4269\/ajtmh.17-0411","article-title":"Analysis of health-care charges in murine typhus: need for improved clinical recognition and diagnostics for acute disease.","volume":"98","author":"Vohra","year":"2018","journal-title":"Am J Trop Med Hyg"}],"container-title":["Emerging Infectious Diseases"],"original-title":[],"deposited":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T16:41:47Z","timestamp":1779813707000},"score":1,"resource":{"primary":{"URL":"https:\/\/wwwnc.cdc.gov\/eid\/article\/32\/6\/25-1015_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":45,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"URL":"https:\/\/doi.org\/10.3201\/eid3206.251015","relation":{},"ISSN":["1080-6040","1080-6059"],"issn-type":[{"value":"1080-6040","type":"print"},{"value":"1080-6059","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6]]}}}