Typhus Fever Outbreak in Pasadena Sparks Confusion: Are Typhus and Typhoid the Same?

Published : Friday, October 5, 2018 | 8:55 AM

Medical sites photographs reveal the physical symptoms of Typhoid (left) and a Typhus rash (right).

The Pasadena Public Health Department announced Friday that typhus fever has reached epidemic levels this year in Pasadena, with 20 residents confirmed to have been infected with the disease.

Due to similar symptoms and similar-sounding names, many people do not know that typhoid and typhus are two different diseases.

Related: Twenty Pasadenans Infected with Typhus Fever as Disease Reaches “Epidemic Levels

Pasadena’s outbreak is caused by flea-borne typhus, also known as murine or endemic typhus, which is a disease carried by fleas infected with bacteria (Rickettsia typhi or Rickettsia felis).

Flea-borne typhus is found regularly in Los Angeles County, especially Pasadena, with most cases occurring in the summer and fall months.

Typhoid and typhus affect millions of people every year worldwide. Here are the differences between the two:


What is Typhoid?

Typhoid is a foodborne illness that infects an estimated 21 million people each year. Transmission is often through contaminated food or water, and symptoms develop within three weeks. Symptoms are usually mild but can be serious. More than 200,000 people die from typhoid every year.

There is a typhoid vaccine that is recommended for most travelers visiting undeveloped nations. To find out more about the vaccine, see our typhoid page, or contact your local Passport Health travel clinic.

What is Typhus?
Typhus is a flea-borne disease that affects thousands of people every year. It is often found in the colder mountainous regions of Africa, South America and Asia. Like typhoid, it most commonly occurs in areas where overcrowding and poor hygiene are common.

The World Health Organization does not have a vaccine against typhus in its registry. However, the WHO does note the risk is low for travelers. Humanitarian relief workers, though, may be susceptible to the illness.

What makes typhoid and typhus different?
Despite having fairly similar names, typhoid and typhus have little in common. One major similarity, and why many have thought them to be the same disease for so long, is the symptoms:

Typhus: Abdominal pain, rash, high fever, cough, headache, joint and muscle pain, nausea, chills, confusion and low blood pressure

Typhoid: Abdominal tenderness, agitation, bloody stool, chills, confusion, delirium, hallucinations, nose bleeds and fatigue.

The few differences in symptoms can make diagnosis problematic. The identification is also, at times, what causes confusion. Both diseases contain the word ‘typhi’ in their official names. Rickettsia typhi is the proper name of typhus and it’s Salmonella typhi for typhoid.

Infection vector, treatment and prevention, however, could not be more different:

Vector: Typhoid infection is foodborne; typhus infection is flea-borne

Treatment: Typhoid treatment involves fluids and electrolytes as well as low-grade antibiotics. Typhus treatment requires specific antibiotics and may need intravenous fluids or oxygen.

Prevention: Typhoid is preventable through vaccination and avoiding contaminated food and water sources. Typhus prevention is more difficult, requiring repellents and insecticides. Maintaining proper hygiene is a must for preventing both diseases.


What’s the Difference Between Typhoid and Typhus? is republished with permission of Passport Health.

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