MMWR Morb Mortal Wkly Rep. 2009 Nov 20;58(45):1267-70.
Murine typhus is a fleaborne rickettsial disease caused by the organism Rickettsia typhi. Symptoms include fever, headache, chills, vomiting, nausea, myalgia, and rash. Although murine typhus is endemic in southern Texas, only two cases had been reported during the past 10 years from Austin, located in central Texas. On August 8, 2008, the Austin/Travis County Department of Health and Human Services (ATCDHHS) contacted the Texas Department of State Health Services (TDSHS) concerning a cluster of 14 illnesses with serologic findings indicative of murine typhus. On August 12, 2008, TDSHS initiated an investigation with assistance from CDC to characterize the magnitude of the outbreak and assess potential animal reservoirs and peridomestic factors that might have contributed to disease. This report summarizes the clinical and environmental findings of that investigation. Thirty-three confirmed cases involved illness comparable to that associated with previous outbreaks of murine typhus. Illness ranged from mild to severe, with 73% of patients requiring hospitalization. Delayed diagnosis and administration of no or inappropriate antibiotics might have contributed to illness severity. Environmental investigation suggested that opossums and domestic animals likely played a role in the maintenance and spread of R. typhi; however, their precise role in the outbreak has not been determined. These findings underscore the need to increase awareness of murine typhus and communicate appropriate treatment and prevention measures through the distribution of typhus alerts before and throughout the peak vector season of March-November.
鼠型斑疹伤寒是由伤寒立克次体引起的一种蚤传播立克次体病。症状包括发热、头痛、寒战、呕吐、恶心、肌痛和皮疹。尽管鼠型斑疹伤寒在得克萨斯州南部为地方性疾病，但在位于得克萨斯州中部的奥斯汀，过去10年中仅报告过2例。2008年8月8日，奥斯汀/特拉维斯县卫生和公众服务部（ATCDHHS）就一组14例血清学检查结果表明为鼠型斑疹伤寒的病例，与得克萨斯州州卫生服务部（TDSHS）进行了联系。2008年8月12日，TDSHS在疾病预防控制中心的协助下展开调查，以确定此次疫情的规模，并评估可能导致疾病发生的潜在动物宿主和家庭周边因素。本报告总结了该调查的临床和环境调查结果。33例确诊病例的病情与之前鼠型斑疹伤寒疫情相关病例的病情相似。病情从轻度到重度不等，73%的患者需要住院治疗。诊断延误以及未使用抗生素或使用了不适当的抗生素可能导致了病情严重。环境调查表明，负鼠和家畜可能在伤寒立克次体的维持和传播中发挥了作用；然而，它们在此次疫情中的确切作用尚未确定。这些发现强调，有必要提高对鼠型斑疹伤寒的认识，并在3月至11月的病媒高峰期之前及期间，通过发布斑疹伤寒警报来宣传适当的治疗和预防措施。
