Saturday, July 19, 2003

Isle murine typhus
incidents increasing

One official says that better
surveillance is identifying more cases

Twelve cases of murine typhus have been recorded in Hawaii in the first half of the year, surpassing the pace of 2002, which was the worst year for the potentially fatal disease since 1947.

Three individuals have been hospitalized for the bacterial infection this year, though not with severe symptoms, state health officials said earlier this week. Eight of this year's cases have been on Maui, three on Oahu and one on Molokai.

Last year, state health officials had recorded eight cases of murine typhus that were contracted before July 1. By the end of the year, the state had a total of 47 cases, with 35 of those cases on Maui.

The state typically has about five reported cases of typhus a year.

Health officials said July through October is the peak season for the disease, which is commonly spread to humans by fleas that have bitten an infected rodent.

Symptoms include fever, rash, body aches and headaches, and can be treated by antibiotics. People with the disease can range from having no symptoms to having severe illness requiring prolonged hospitalization. It can cause encephalitis, renal failure, multiple organ failure, shock and death.

Dr. Paul Kitsutani, of the federal Centers for Disease Control and Prevention, said officials are not sure why murine typhus is on the rise, but increased awareness and better surveillance by physicians may have something to do with the increase in reported cases, he said.

Also, with more people being outdoors, more are exposed to fleas, Kitsutani said.

Due to dry summer conditions, rodents may be coming into human habitats for food. Earlier this year, Maui Vector Control did a round of poisoning, and the number of mice has gone down, according to the state Department of Health.

Last year, a Maui man developed encephalitis and kidney failure after contracting murine typhus. He was discharged from the hospital but had damage to his nervous system.

The state public health laboratory now provides free blood testing for murine typhus. Previously, samples had to be sent to the mainland.


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