Surveillance of Flea-Borne Typhus in California, 2011–2019

Kyle Yomogida Center for Animal Disease Modeling and Surveillance, School of Veterinary Medicine, University of California, Davis, California;
Vector-Borne Disease Section, California Department of Public Health, Sacramento, California;

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Anne Kjemtrup Vector-Borne Disease Section, California Department of Public Health, Sacramento, California;

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Beatriz Martínez-López Center for Animal Disease Modeling and Surveillance, School of Veterinary Medicine, University of California, Davis, California;

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Mireille Ibrahim Los Angeles County Department of Public Health, Acute Communicable Disease Control Program – Morbidity Unit, Los Angeles, California;

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Zuelma Contreras Los Angeles County Department of Public Health, Acute Communicable Disease Control Program – Morbidity Unit, Los Angeles, California;

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Van Ngo Los Angeles County Department of Public Health, Acute Communicable Disease Control Program – Morbidity Unit, Los Angeles, California;

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Umme-Aiman Halai Los Angeles County Department of Public Health, Acute Communicable Disease Control Program – Morbidity Unit, Los Angeles, California;

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Sharon Balter Los Angeles County Department of Public Health, Acute Communicable Disease Control Program – Morbidity Unit, Los Angeles, California;

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Matt Feaster City of Pasadena Public Health Department, Pasadena, California;

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Matthew Zahn Orange County Health Care Agency, Santa Ana, California;

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Eric Shearer Orange County Health Care Agency, Santa Ana, California;

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Rochelle Sorvillo Orange County Health Care Agency, Santa Ana, California;

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Nora Balanji Long Beach Department of Health and Human Services, Communicable Disease Control Program, Long Beach, California

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Cindy Torres Long Beach Department of Health and Human Services, Communicable Disease Control Program, Long Beach, California

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Belinda Prado Long Beach Department of Health and Human Services, Communicable Disease Control Program, Long Beach, California

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Charsey Porse Vector-Borne Disease Section, California Department of Public Health, Sacramento, California;

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Vicki Kramer Vector-Borne Disease Section, California Department of Public Health, Sacramento, California;

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ABSTRACT.

Flea-borne typhus (FBT), also referred to as murine typhus, is an acute febrile disease in humans caused by the bacteria Rickettsia typhi. Currently, cases of FBT are reported for public health surveillance purposes (i.e., to detect incidence and outbreaks) in a few U.S. states. In California, healthcare providers and testing laboratories are mandated to report to their respective local public health jurisdictions whenever R. typhi or antibodies reactive to R. typhi are detected in a patient, who then report cases to state health department. In this study, we characterize the epidemiology of flea-borne typhus cases in California from 2011 to 2019. A total of 881 cases were reported during this period, with most cases reported among residents of Los Angeles and Orange Counties (97%). Demographics, animal exposures, and clinical courses for case patients were summarized. Additionally, spatiotemporal cluster analyses pointed to five areas in southern California with persistent FBT transmission.

    • Supplemental Materials (PDF 261.52 KB)

Author Notes

Financial support: K. Y. acknowledges funding support from the Pacific Southwest Regional Center of Excellence for Vector-Borne Diseases, funded by the U.S. Centers for Disease Control and Prevention (Cooperative Agreement 1U01CK000516).

Disclosure: The findings and conclusions in this article are those of the authors and do not necessarily represent the views or opinions of the California Department of Public Health or the California Health and Human Services Agency.

Authors’ addresses: Kyle Yomogida, Center for Animal Disease Modeling and Surveillance, School of Veterinary Medicine, University of California, Davis, CA, and Vector-Borne Disease Section, California Department of Public Health, Sacramento, CA, E-mail: kyle.yomogida@cdph.ca.gov. Anne Kjemtrup, Charsey Porse, and Vicki Kramer, Vector-Borne Disease Section, California Department of Public Health, Sacramento, CA, E-mails: anne.kjemtrup@cdph.ca.gov, charsey.porse@cdph.ca.gov, and vicki.kramer@cdph.ca.gov. Beatriz Martinez-Lopez, Center for Animal Disease Modeling and Surveillance, School of Veterinary Medicine, University of California, Davis, CA, E-mail: beamartinezlopez@ucdavis.edu. Mireille Ibrahim, Zuelma Contreras, Van Ngo, Umme-Aiman Halai, and Sharon Balter, Los Angeles County Department of Public Health, Acute Communicable Disease Control Program – Morbidity Unit, Los Angeles, CA, E-mails: mibrahim2@ph.lacounty.gov, zcontrera@ph.lacounty.gov, vngo@ph.lacounty.gov, uhalai@ph.lacounty.gov, and sbalter@ph.lacounty.gov. Matt Feaster, City of Pasadena Public Health Department, Pasadena, CA, E-mail: mfeaster@cityofpasadena.net. Matthew Zahn, Eric Shearer, and Rochelle Sorvillo, Orange County Health Care Agency, Santa Ana, CA, E-mails: mzahn@ochca.com, eshearer@ochca.com, and rsorvillo@ochca.com. Nora Balanji, Cindy Torres, and Belinda Prado, Long Beach Department of Health and Human Services, Communicable Disease Control Program, Long Beach, CA, E-mails: nora.balanji@longbeach.gov, cindy.torres@longbeach.gov, and. Belinda.prado@longbeach.gov.

Address correspondence to Kyle Yomogida, Center for Animal Disease Modeling and Surveillance, School of Veterinary Medicine, University of California, Davis, One Shields Ave., 2108 Tupper Hall, Davis, CA 95616. E-mail: kyomogida@ucdavis.edu or kyle.yomogida@gmail.com
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