A 12-year-old Waco girl spent six days in a pediatric ICU after flea-borne typhus was missed twice and progressed to septic shock, underscoring how severe the infection can become within days.
Nearly 80% of 149 confirmed or probable adult cases in a 2019-2023 UTMB Galveston review were hospitalized, 28% of those needed ICU care, and two patients died.
Texas recorded 847 cases in 2024 — the state's highest annual total on record — after more than 6,700 cases were reported from 2008 to 2023, with about 70% hospitalized.
Researchers and physicians link the resurgence to mild winters, warming temperatures, expanding cat and opossum flea cycles, and limited flea control; cases now extend beyond South Texas into Central Texas and major metro areas.
Because early symptoms mimic flu, COVID-19 or strep and tests can be negative early, CDC guidance calls for starting doxycycline on clinical suspicion rather than waiting for lab confirmation.
As Texas faces a record typhus outbreak, are other states prepared for this rapidly expanding public health threat?
Flea-borne typhus was nearly eradicated. What allowed this forgotten disease to stage a major comeback across the U.S.?
With pets now the main carriers of typhus into homes, is your current flea control regimen truly protecting your family?
Flea-Borne Typhus in Texas Hits All-Time High: Causes, Consequences, and the Path Forward
Overview
Texas is facing a major flea-borne typhus crisis, with cases rising sharply over recent decades. In the 1990s, the state averaged about 200 cases each year, but between 2010 and 2019, this number increased 12-fold. From 2008 to 2023, Texas reported over 6,700 cases, and in 2024 alone, a record 847 cases were documented. The impact is severe, as about 70% of those diagnosed needed hospitalization. This surge highlights the growing threat of typhus in Texas and the urgent need for effective public health responses.