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Volume 9, Number 10—October 2003

Dispatch

Flying Squirrel–associated Typhus, United States

Mary G. Reynolds*Comments to Author , John W. Krebs*, James A. Comer*, John W. Sumner*, Thomas C. Rushton†, Carlos E. Lopez‡, William L. Nicholson*, Jane A. Rooney§, Susan E. Lance-Parker¶, Jennifer H. McQuiston*, Christopher D. Paddock*, and James E. Childs*
Author affiliations: *Centers for Disease Control and Prevention, Atlanta, Georgia, USA; †Marshall University, Huntington, West Virginia, USA; ‡Atlanta I.D. Group, Atlanta, Georgia, USA; §West Virginia Division of Public Health, Charleston, West Virginia, USA; ¶Georgia Division of Public Health, Atlanta, Georgia, USA

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Table

Epidemiologic and clinical characteristics of flying squirrel–associated typhus fever in the United States, 1984–2002a

Characteristic
Case no.
I
IIb
III
IV
Sex
Male
Female
Male
Male
Age (y)
54
54
44
57
State of residence
Massachusetts
North Carolina
West Virginia
Georgia
Mo of onset
February 1998
September 1999
January 2002
March 2002
Flying squirrel contact
Y
Y
Y
Y
Serologic titer (no. d from onset)




IgG Rickettsia prowazekii
4,096 (10)
nd
128 (53)
8,192 (7)
8,192 (13)
32,768 (38)
8,192 (23)
IgG R. typhi
nd
nd
<32 (53)
4,096 (7)
4,096 (13)
4,096 (23)
IgM R. prowazekii
nd
2,048 (18)
1,024 (53)
nd
IgM R. typhi
nd
512 (18)
1,024 (53)
nd
Symptoms




Max fever (°C)
nr
40°C
38°C
40°C
Chills
Y
nr
Y
Y
Headache
Y
Y
Y
Y
Rash (type, location) nr Y (macular, trunk) N Yc

aIg, immunoglobulin; Y, yes; N, no; nd, not done; nr, not recorded.
bRecurrent illness, first episode January 1999, flying squirrel contact, rash at that time. Other symptoms associated with both episodes. Serologic titer from second episode.
cRash herpetic, not directly attributable to R. prowazekii infection but commonly seen in context of classic louse-borne epidemic typhus (8).

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