{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T07:43:43Z","timestamp":1792827823127,"version":"4.5.0"},"reference-count":45,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,5,3]]},"abstract":"<jats:p>\n                    Flea-borne (murine) typhus is a global rickettsiosis caused by\n                    <jats:italic>Rickettsia typhi<\/jats:italic>\n                    . Although flea-borne typhus is no longer nationally notifiable, cases are reported for surveillance purposes in a few U.S. states. The infection is typically self-limiting, but may be severe or life-threatening in some patients. We performed a retrospective review of confirmed or probable cases of fatal flea-borne typhus reported to the Texas Department of State Health Services during 1985\u20132015. When available, medical charts were also examined. Eleven cases of fatal flea-borne typhus were identified. The median patient age was 62 years (range, 36\u201384 years) and 8 (73%) were male. Patients presented most commonly with fever (100%), nausea and vomiting (55%), and rash (55%). Respiratory (55%) and neurologic (45%) manifestations were also identified frequently. Laboratory abnormalities included thrombocytopenia (82%) and elevated hepatic transaminases (63%). Flea or animal contact before illness onset was frequently reported (55%). The median time from hospitalization to administration of a tetracycline-class drug was 4 days (range, 0\u20135 days). The median time from symptom onset to death was 14 days (range, 1\u201334 days). Flea-borne typhus can be a life-threatening disease if not treated in a timely manner with appropriate tetracycline-class antibiotics. Flea-borne typhus should be considered in febrile patients with animal or flea exposure and respiratory or neurologic symptoms of unknown etiology.\n                  <\/jats:p>","DOI":"10.4269\/ajtmh.16-0465","type":"journal-article","created":{"date-parts":[[2017,3,14]],"date-time":"2017-03-14T13:25:30Z","timestamp":1489497930000},"page":"1088-1093","source":"Crossref","is-referenced-by-count":35,"title":["Fatal Flea-Borne Typhus in Texas: A Retrospective Case Series, 1985\u20132015"],"prefix":"10.4269","volume":"96","author":[{"given":"Emily G.","family":"Pieracci","sequence":"first","affiliation":[{"name":"Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia."},{"name":"Epidemic Intelligence Service, Center for Surveillance, Epidemiology and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Evert","sequence":"additional","affiliation":[{"name":"Texas Department of State Health Services, Austin, Texas."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naomi A.","family":"Drexler","sequence":"additional","affiliation":[{"name":"Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bonny","family":"Mayes","sequence":"additional","affiliation":[{"name":"Texas Department of State Health Services, Austin, Texas."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inger","family":"Vilcins","sequence":"additional","affiliation":[{"name":"Texas Department of State Health Services, Austin, Texas."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Huang","sequence":"additional","affiliation":[{"name":"Austin\/Travis County Health and Human Services Department, Austin, Texas."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill","family":"Campbell","sequence":"additional","affiliation":[{"name":"Austin\/Travis County Health and Human Services Department, Austin, Texas."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Casey Barton","family":"Behravesh","sequence":"additional","affiliation":[{"name":"Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher D.","family":"Paddock","sequence":"additional","affiliation":[{"name":"Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"ref1","series-title":"Annu Rev Entomol","first-page":"553","article-title":"Epidemiology of murine typhus","volume":"35","author":"Azad","year":"1990"},{"key":"ref2","series-title":"MMWR Morb Mortal Wkly Rep","first-page":"74","article-title":"Summary of notifiable diseases\u2014United States, 2002","volume":"51","author":"CDC","year":"2004"},{"key":"ref3","series-title":"Flea-Borne Typhus in Texas (2003\u20132013)","first-page":"57","author":"Evert","year":"2015"},{"key":"ref4","series-title":"Emerg Infect Dis","first-page":"549","article-title":"Geographic association of Rickettsia felis-infected opossums with human murine typhus, Texas","volume":"8","author":"Boostrom","year":"2002"},{"key":"ref5","series-title":"Arch Pediatr Adolesc Med","first-page":"396","article-title":"Clinical, 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