Definition

• A collection of infectious diseases caused by 3 rickettsial species
  • Endemic (murine) typhus (flea-borne)
    • Illness of abrupt onset; nonspecific symptoms, including chills, fever, headache, myalgia, arthralgia, nausea, and malaise, commonly with cough and sometimes with rash
    • Usually of mild to moderate severity, but may require intensive care unit (ICU) admission
    • Low fatality rate
  • Epidemic typhus (louse-borne)
    • Acute febrile illness with characteristic clinical features, such as high fever, prostration, rash, cough, severe myalgia, severe headache, and photophobia
    • Severe illness with significant fatality rate
  • Scrub typhus (chigger-borne)
    • Acute febrile illness with characteristic clinical features, such as eschar, lymphadenopathy, and rash in addition to fever, headache, cough, and gastrointestinal symptoms
    • Variable severity—from mild and self-limiting to fatal

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