Officials say typhus cases not a repeat of outbreak

By Timothy Hurley
Advertiser Staff Writer

Six more cases of murine typhus have been reported in Hawai'i, bringing the year's total to 18 — about the same pace as last year's record outbreak.

Health officials said yesterday they don't believe the state will repeat last year, which reached 47 cases, the highest annual figure since 1947.

State epidemiologist Paul Effler said this year's higher-than-normal cases — including a doubling of cases on O'ahu, to six — probably reflects greater awareness resulting from last year's outbreak.

Previously, the Islands reported an average of four to five cases of murine typhus a year, Effler said, but he is hoping that efforts to educate doctors and parents about testing and treatment will result in more accurate reporting.

The bacteria that cause the disease are carried on rodents, by fleas. Infection occurs when flea feces enters a flea bite wound or is inhaled.

Maui experienced the brunt of cases last year — 35 — and the Valley Isle leads again this year with 11 cases, followed by six on O'ahu' and one on Moloka'i.

As was the case last year, some of the cases on Maui worsened to the point where 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 chance of serious complications, but most people don't know they are infected until they become sick after an incubation period of one to two weeks.

Lorie Whitsett, a state epidemiology specialist on Maui, said she suspects the Valley Isle will fall well short of the typhus levels seen last year.

"Most of the cases occur in the late summer, and we're almost past that," she said. "We'll probably see a few more cases, but I would be surprised to see a dozen, for example."

Whitsett said vector-control officials started rodent control early this year, and haven't seen the overwhelming numbers of mice seen last year. The 2002 outbreak corresponded with an explosion in Maui's mouse population in late spring and summer, when rodents and fleas are most active.

Whitsett said last year's dengue fever control work also may have helped eliminate conditions encouraging a typhus outbreak.