Typhus infection
reported on Oahu

Health officials say the
10 cases statewide fall
within the norm

Workers spread poison to kill rodents

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By Gary T. Kubota
gkubota@starbulletin.com

A Waianae man is the first confirmed typhus patient on Oahu this year, state health officials said yesterday.

The Oahu patient and another newly verified case in Kihei, Maui, have brought the statewide total of the rodent-borne disease to 10, they said.

"The increase in the number of cases is a concern for us, but we still have to monitor the trend over the next few weeks," said Dr. Paul Kitsutani, a medical officer with the federal Centers for Disease Control and Prevention assigned to Oahu. Kitsutani said the numbers were not enough to call the disease an epidemic.

He said the number of cases fall within the range of one to 10 statewide per year in the last decade.

There are eight cases on Maui, including seven in Kihei and one in Lahaina; one in Eleele, Kauai; and now one on Oahu.

Kitsutani said Maui's average is three to five confirmed cases annually, but this year's numbers may have risen for a combination of reasons, including an increase in testing for diseases following last year's dengue fever outbreak that occurred mainly on the Valley Isle.

"Certainly the effects of dengue have helped typhus surveillance," he said.

Kitsutani said half of the confirmed cases of typhus took place before the explosion in the rodent population in June.

The latest two patients contracted the disease in mid-July, according to health officials.

The man who contracted the disease in Waianae was hospitalized for a time but suffered no complications, Kitsutani said.

Murine typhus is spread by fleas that have bitten rodents infected with the disease.

State health officials say the symptoms, stemming from a bacteria called Rickettsia typhi, are similar to a flu, with a fever, rash, body ache and headache.

Murine typhus is treatable with antibiotics, and anyone who has had the disease gains an immunity to it, Kitsutani said.

But the disease can sometimes lead to complications.

Of the 10 adults who are known to have contracted the disease in Hawaii this year, four have been hospitalized, one of them suffering from encephalitis and kidney failure.

There has been a notable increase of field mice in the Kihei residential areas. Health officials said they could not conclude that the increased mice population is a direct cause for the typhus cases.

Oahu appears to have no significant problems with mice, said state Department of Health spokesperson Janice Okubo. She said the vector control crew did some trapping in the Waianae area because of a complaint but the level of mice was normal.