{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T19:24:17Z","timestamp":1791141857885,"version":"4.1.0"},"reference-count":30,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012,6,1]]},"abstract":"<jats:p>Murine typhus, caused by <jats:italic>Rickettsia typhi<\/jats:italic> and transmitted mainly by the rat fleas, <jats:italic>Xenopsylla cheopis<\/jats:italic>, has emerged in the field of travel medicine. We analyzed retrospectively the epidemiological, clinical, and biological characteristics of the 32 murine typhus cases that were diagnosed during the past 3 years at the World Health Organization Collaborative Center for Rickettsial diseases, Marseille, France. All of the cases occurred in travelers and most of them had returned from Africa (<jats:italic>N<\/jats:italic> = 13 of 32) and South-east Asia (<jats:italic>N<\/jats:italic> = 12 of 32). Exposure to rats was reported only in a few (<jats:italic>N<\/jats:italic> = 2 of 32) patients. Almost half of the cases were diagnosed in August and September. Only four patients presented the classic triad: fever, rash, and headache. Moreover, we report the first known cases of a hemophagocytic syndrome associated with this disease. Murine typhus must be considered as an etiologic agent of febrile illness in returning travelers, particularly in those with unspecific symptoms.<\/jats:p>","DOI":"10.4269\/ajtmh.2012.11-0794","type":"journal-article","created":{"date-parts":[[2012,6,4]],"date-time":"2012-06-04T20:16:06Z","timestamp":1338840966000},"page":"1049-1053","source":"Crossref","is-referenced-by-count":84,"title":["Murine Typhus in Returned Travelers: A Report of Thirty-Two Cases"],"prefix":"10.4269","volume":"86","author":[{"given":"Ga\u00eblle","family":"Walter","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth","family":"Botelho-Nevers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Socolovschi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Didier","family":"Raoult","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Parola","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"R1","series-title":"Clin Microbiol Rev","first-page":"694","article-title":"Rickettsioses as paradigms of new or emerging infectious diseases","volume":"10","author":"Raoult","year":"1997"},{"key":"R2","series-title":"Clin Infect Dis","first-page":"913","article-title":"Murine typhus: an unrecognized suburban vectorborne disease","volume":"46","author":"Civen","year":"2008"},{"key":"R3","series-title":"Int J Infect Dis","first-page":"e667","article-title":"Fleas and flea-borne diseases","volume":"14","author":"Bitam","year":"2010"},{"key":"R4","series-title":"Emerg Infect Dis","first-page":"677","article-title":"Murine typhus in travelers returning from Indonesia","volume":"4","author":"Parola","year":"1998"},{"key":"R5","series-title":"Emerg Infect Dis","first-page":"256","article-title":"Rickettsial infections and fever, Vientiane, Laos","volume":"12","author":"Phongmany","year":"2006"},{"key":"R6","series-title":"Ann Emerg Med","first-page":"43","article-title":"Update on emerging infections: news from the Centers for Disease Control and Prevention. 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