Posted on: Thursday, July 17, 2003

Maui adds five cases of murine typhus

By Timothy Hurley
Advertiser Maui County Bureau

Five more cases of murine typhus have been reported in Hawai'i, bringing this year's total to 12 — the same year-to-date figure recorded during last year's record-breaking outbreak.

Although the number of cases already has exceeded a typical year in the Islands, health officials yesterday said that it is too early to tell whether the state is on track for a repeat of last year, when there were 47 cases, the most in any year since 1947.

Most of the cases last year occurred in late summer, they said.

"We're watching it closely and hoping it doesn't reach those levels," said Lorie Whitsett, a state epidemiology specialist on Maui, the island hardest hit last year, with 35 cases.

Maui is again experiencing the brunt this year, with eight cases, half of them in the Kihei area. There also have been three cases reported on O'ahu and one on Moloka'i.

Whitsett said two of this year's Maui cases advanced to the point where the victims required hospitalization.

Symptoms include fever, headaches, body aches, nausea, vomiting, abdominal pain and a rash. The illness is treated with antibiotics.

Early treatment reduces the chances of serious complications, but most people don't even know they are infected until they fall ill after an incubation period of one to two weeks. Infection occurs when flea feces enters a flea bite wound or is inhaled.

Hawai'i typically experiences four to five cases of murine typhus a year, according to the state Department of Health.

Last year's outbreak corresponded with a severe increase in Maui's mouse population during the late spring and summer, when rodents and fleas are most active and abundant.

Herb Matsubayashi, Maui District Environmental Health Programs chief, said that when monitoring traps first detected an upswing in the mouse population this year, crews were dispatched to scatter an oat mixture containing the rodenticide zinc phosphide on vacant lands.

Since then, the mouse count appears to have subsided, he said.

Rats are the primary reservoir for the disease, but mice and other small animals could be contributing to the problem, officials said.