{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T16:32:24Z","timestamp":1788021144640,"version":"build-2784847793"},"reference-count":28,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,4,3]]},"abstract":"<jats:p>The incidence of murine typhus in Israel has decreased substantially since 1950 to a low of 0.04\/100,000 population in 2010. We present the experience of a single university medical center in central Israel. Hospitalized patients serologically positive for <jats:italic>Rickettsia typhi<\/jats:italic> by indirect immunofluorescence antibody assay during 2006\u20132016 were retrospectively identified. Clinical and laboratory data from patients\u2019 charts were used to analyze disease trends and distribution. Seventy-eight patients were studied (mean age: 27.9 years), mostly of Arab ethnicity (68, 87.2%). Seventy-one (91%) patients resided in two large mixed Jewish-Arab cities\u2014Lod and Ramla. The incidence of murine typhus among the Arab population in Lod increased 8.4-fold from 6.4\/100,000 in 2006 to a peak of 53.4\/100,000 in 2013. The average annual incidence among Arabs in Ramla was 10.1\/100,000. Among Jews, incidences were 0.8\/100,000 in Lod and 0.4\/100,000 in Ramla. The classical triad of fever, headache, and rash was noted in 20.8% patients. Substantial morbidity included prolonged fever before hospitalization and hospital stay (mean of 8.4 and 5.1 days, respectively), and severe complications in six patients, including pneumonitis in three patients, and splenic infarctions, pericardial effusion, and retinitis, each in one. One previously healthy patient died of multiorgan failure. The study describes a high incidence of murine typhus with a recent upsurge in an urban setting in central Israel. High morbidity and a single fatal outcome challenge the concept of murine typhus being a mild disease. The study calls for better rodent control and sanitation measures in the affected neighborhoods.<\/jats:p>","DOI":"10.4269\/ajtmh.18-0076","type":"journal-article","created":{"date-parts":[[2019,2,12]],"date-time":"2019-02-12T07:02:43Z","timestamp":1549954963000},"page":"952-956","source":"Crossref","is-referenced-by-count":9,"title":["High Morbidity Due to Murine Typhus Upsurge in Urban Neighborhoods in Central Israel"],"prefix":"10.4269","volume":"100","author":[{"given":"Evgeny","family":"Rogozin","sequence":"first","affiliation":[{"name":"Department of Medicine B, Assaf Harofeh Medical Center, Zerifin, Israel;"},{"name":"Department of Medicine B, Assaf Harofeh Medical Center, Zerifin, Israel;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsilia","family":"Lazarovitch","sequence":"additional","affiliation":[{"name":"The Microbiology Laboratory, Assaf Harofeh Medical Center, Zerifin, Israel;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam","family":"Weinberger","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Assaf Harofeh Medical Center, Zerifin, Israel;"},{"name":"Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Clin Infect Dis","first-page":"913","article-title":"Murine typhus: an unrecognized suburban vectorborne disease","volume":"46","author":"Civen","year":"2008"},{"key":"b2","series-title":"Am J Trop Med Hyg","first-page":"451","article-title":"Rickettsial infections in southeast Asia: implications for local populace and febrile returned travelers","volume":"91","author":"Aung","year":"2014"},{"key":"b3","series-title":"Int J Infect Dis","first-page":"126","article-title":"Syndromic classification of rickettsioses: an approach for clinical 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