Typhus vs Typhoid Fever: What's the difference?
Q&A With Cedars-Sinai Infectious Diseases Expert
Typhus and typhoid fever have both been in the news as reported cases surface in Los Angeles.
Although the names of these infections are almost identical—and their symptoms are very similar—they are completely different diseases. To clear up any confusion, we asked Jonathan D. Grein, MD, director of Hospital Epidemiology at Cedars-Sinai, to explain how these diseases compare to each other.
How does typhus differ from typhoid fever?
Both diseases are infections, but they're caused by different types of bacteria that are spread in different ways. The kind of typhus we tend to see in the U.S. is spread by fleas that catch the disease from rats and opossums. Typhoid fever is spread through food that's come into contact with fecal bacteria. For example, a food worker might use the restroom, not wash their hands and then contaminate the food they're handling, which infects the person eating it.
What are the symptoms?
The clinical symptoms can be very similar: fever, muscle aches, headache and, possibly, a rash on the trunk or back.
How can someone tell the difference between the two diseases?
Symptoms like diarrhea or constipation are more commonly seen with typhoid fever than with typhus. A physician can make a diagnosis using different types of blood tests.
Contact your physician if you develop any of the symptoms like fever, muscle aches, headache and a rash on the trunk or back. Make sure you tell your healthcare provider if you've been traveling recently. A complete travel history could be critical to getting the right diagnosis.
Why are the names so similar?
People thought they were the same disease until the 1800s, when a physician determined that they were different infections.
How common are these infections?
Los Angeles County sees an average of about 50 flea-borne typhus cases each year, except in 2018 when an outbreak caused that number to double. Typhoid fever, on the other hand, is less common in the U.S. It often manifests after a patient has traveled to Asia or India. The California Department of Public Health gets reports of about 75 cases of typhoid fever in the state each year.
How are these diseases treated?
Fortunately, both infections are treatable. They each respond to different types of antibiotics.
How can people avoid catching these infections?
You can reduce your risk of getting flea-borne typhus by avoiding contact with fleas. For example, make sure your pets are treated with flea protection. Also, keep rodents away from your home and workplace. You can avoid typhoid fever by getting vaccinated and carefully choosing what you eat or drink when you travel to countries where typhoid fever is more common. Speak with your doctor before you travel to see if a typhoid vaccine is appropriate. Stick to bottled water and fully cooked food or fruits and vegetables that must be peeled. Washing your hands also is important.
What should people do if they develop symptoms of these diseases?
Contact your physician if you develop any of the symptoms like fever, muscle aches, headache and a rash on the trunk or back. Make sure you tell your healthcare provider if you've been traveling recently. A complete travel history could be critical to getting the right diagnosis.
Read more on the Cedars-Sinai blog: Typhus: What You Need to Know