Volume 26, Number 5—May 2020
Research Letter
Rise in Murine Typhus in Galveston County, Texas, USA, 2018
Table
Clinical and epidemiologic features of patients with confirmed and probable murine typhus in Galveston County, Texas, 2018
| Feature | No. (%) patients |
p value* | ||
|---|---|---|---|---|
| Confirmed cases, n = 12 | Probable cases, n = 28 | Total, n = 40 | ||
| Fever | 12 (100) | 28 (100) | 40 (100) | 0.99 |
| Malaise | 10 (83) | 26 (93) | 36 (90) | 0.57 |
| Myalgia | 11 (92) | 23 (82) | 34 (85) | 0.65 |
| Headache | 9 (75) | 20 (71) | 29 (73) | 0.99 |
| Anorexia | 7 (58) | 15 (54) | 22 (55) | 0.99 |
| Nausea/vomiting | 3 (25) | 19 (68) | 22 (55) | 0.02 |
| Chills | 1 (8) | 8 (29) | 9 (23) | 0.23 |
| Abdominal pain | 0 | 5 (18) | 5 (13) | 0.30 |
| Rash | 7 (58) | 13 (46) | 20 (50) | 0.73 |
| Hepatic transaminase elevation† | 5 (42) | 12 (43) | 17 (43) | 0.99 |
| Thrombocytopenia‡ | 6 (50) | 5 (18) | 11 (28) | 0.06 |
| Flea exposure§ | 5 (42) | 17 (61) | 22 (55) | 0.32 |
| Opossum exposure¶ | 6 (50) | 20 (71) | 26 (65) | 0.28 |
| Dog ownership# | 5 (42) | 18 (64) | 23 (58) | 0.30 |
| Cat ownership# | 6 (50) | 7 (25) | 13 (33) | 0.15 |
| Stray dog exposure# | 2 (17) | 4 (14) | 6 (15) | 0.99 |
| Stray cat exposure# | 4 (33) | 16 (57) | 20 (50) | 0.30 |
| Rodent exposure** | 4 (33) | 6 (21) | 10 (25) | 0.45 |
| Raccoon exposure¶ | 2 (17) | 3 (11) | 5 (13) | 0.63 |
*Fisher exact test was performed to compare the frequency of features in those with confirmed versus probable murine typhus. With the exception of more nausea/vomiting in the probable cases group, there were no significant differences between the groups.
†Defined as any aspartate aminotransferase or alanine aminotransferase level over the reference laboratories’ upper limit of normal.
‡Defined as <150,000 platelets/μL blood.
§Patients were asked whether fleas were present in their environment (i.e., yard, neighborhood, house, work) or if they had been bitten by fleas in the 3 weeks before disease onset.
¶Patients were asked whether other wild animals were present in their environment (i.e., yard, neighborhood, house, work). If they answered yes, they were asked to specify the type of animal.
#Patients were asked whether dogs or cats were present in their environment (i.e., yard, neighborhood, house, work). If they answered yes, they were asked whether these animals were owned or strays.
**Patients were asked whether rodents were present in their environment (i.e., yard, neighborhood, house, work).