Typhus: symptoms, treatment and how to avoid it

Typhus sounds old-school, but it still shows up in parts of the world and after disasters. If you get a high fever, severe headache, and a rash after travel or from crowded, unhygienic places, don’t ignore it. Typhus is caused by bacteria spread by tiny carriers — lice, fleas, or mites — and it needs quick treatment to avoid serious complications.

How typhus spreads

There are three common types: epidemic typhus (spread by body lice), murine or endemic typhus (spread by fleas from rats), and scrub typhus (spread by chigger mites). The bacteria don’t jump directly from person to person; they hitch a ride on those bugs or their feces. Close contact, overcrowded housing, poor sanitation, and rodent infestations raise the risk. Travelers to rural areas, relief workers, and people living in shelters are higher risk groups.

Tell-tale signs and when to see a doctor

Symptoms usually show up 1–2 weeks after exposure. Expect sudden fever, intense headache, muscle aches, and sometimes confusion or light sensitivity. A rash often appears a few days into the illness, but not always. If you have high fever plus a rash after travel or exposure to lice, fleas, or rodents, get medical help right away. Untreated typhus can lead to pneumonia, meningitis, kidney problems, or even death in severe cases.

Doctors diagnose typhus with a clinical exam and lab tests like blood antibody tests or PCR. But because tests can take time, clinicians often start treatment based on symptoms and exposure history.

Treatment is straightforward and effective when started early. Doxycycline is the first-choice antibiotic for most typhus types and usually brings rapid improvement within 48 hours. For pregnant people or when doxycycline isn’t suitable, doctors may choose alternatives such as azithromycin — your provider will decide what’s safest. Follow the full antibiotic course and keep hydrated. If symptoms get worse or you don’t improve in a couple of days, revisit your clinician.

Prevention focuses on avoiding the bugs. Keep living areas clean, seal gaps that let rodents in, and use effective flea control on pets. When traveling to risk areas, use insect repellent with DEET or picaridin, wear long sleeves and permethrin-treated clothing, and avoid sleeping on bare ground. In outbreak settings, public health measures like delousing and rodent control are key.

If you’re worried about exposure or have symptoms, contact a healthcare provider promptly. Quick diagnosis and the right antibiotic make typhus much less dangerous. For more practical tips on infections, travel safety, and medications, check resources at CFSPharmacy.com — and keep your travel and home environments pest-free.