Posted on: Thursday, May 8, 2003

Fourth case of typhus reported on Maui

By Christie Wilson
Advertiser Neighbor Island Editor

WAILEA, Maui — A fourth case of murine typhus has been reported on Maui, as workers continue efforts to keep the island's mouse population in check.

The only other confirmed case this year occurred on O'ahu, according to the state Department of Health.

Last year, there were 47 cases in Hawai'i, the most in any year since 1947. Thirty-five of those cases were reported on Maui.

Hawai'i typically experiences four to five cases of murine typhus a year. Symptoms include fever, headaches, body aches, nausea, vomiting, abdominal pain and a rash.

Infection occurs when flea feces enters a flea bite wound or is inhaled. Most people don't even know they are infected until they fall ill after an incubation period of one to two weeks.

Murine typhus is not transmitted from person to person.

An explosion in Maui's mouse population is believed to have triggered last year's outbreak, although studies have not been conducted to confirm a clear association between the two events.

A recently published Department of Health report said nearly 40 percent of those infected with the disease in 2002 required hospitalization. Those 18 patients, ranging in age from 9 to 50, were hospitalized two to 41 days.

There were no fatalities, but some of the patients suffered serious complications such as renal failure, gastrointestinal bleeding and inflammation of the brain.

Dr. Lorrin Pang, head of the Maui District Health Office, said the department jumped on the problem early this year at the first sign of an increase in mice caught at monitoring traps in South and West Maui. He said widespread use of an oat mixture containing the rodenticide zinc phosphide is having an effect on the mouse population in Kihei, where more than half of the Maui cases were reported last year.

Crews are having a more difficult time in West Maui, Pang said. Federal restrictions limit use of the poison to less-efficient bait stations in an area from Ma'alaea Harbor to Lahaina in order to protect a population of nene geese.

The next few months will tell whether the rodent control program is a success, officials said. Last year's outbreak peaked in the months of July, August and September.