“I have a story for you,” said my neighbor Paul Nawrocki when I ran into him recently. “I nearly died last year.”
Paul told me his story. I think it’s worth sharing as a Public Service Announcement.
One Sunday at the end of March 2011, Paul thought he’d come down with the flu. “By Wednesday, I was really sick,” said Paul, who remembers that he couldn’t keep anything down, even water. “I knew something was seriously wrong so I went to the doctor [on Thursday].” Paul’s wife Jill remembers that in addition to fever, chills and other flu-like symptoms, Paul “couldn’t lay down flat because he couldn’t breathe.”
Paul’s general practitioner Dr. Thomas Pocock of Verdugo Hills Hospital ordered blood tests but the tests came back negative. Dr. Pocock told Paul to come back the next day: Friday, April 1. “I was in pretty bad shape,” remembers Paul about his April Fool’s Day admittance to the hospital.
A Sudden Turn for the Worst
Jill had visited Paul early Friday evening. Back at home, Jill got a call from Dr. Pocock. Paul had been rushed to the ICU. “It was surreal,” remembers Jill. “It happened so fast."
Says Paul, "when you wake up in the hospital at 10:00 p.m. on a Friday night and your doctor is standing over your bed saying he’s 'a little worried,' you know something is seriously wrong.”
Paul’s fever had spiked to 105 degrees, his blood pressure had dropped alarmingly, and his blood oxygen levels were so low he was danger of hypoxia, which can cause hallucinations, seizures, comas and even death. His liver had shut down, his stomach had shut down, and he had internal bleeding.
Less dramatically, Paul had also developed a rash on his chest. And it was the rash that finally gave Dr. Pocock the clue to the disease.
Paul had Endemic Murine Typhus.
What Is Murine Typhus?
According to the County of Los Angeles Department of Public Health, Endemic Murine Typhus is an infectious disease caused by bacteria (either Rickettsia typhi or Rickettsia felis) that is transmitted by the bites of infected fleas. Joe Ramirez, a Health Specialist with the Vector Borne Disease Surveillance Unit, said that any animal can carry infected fleas but the highest percentage is found on infected rats, opossums and feral cats.
Feline-loving Paul had started feeding a pair of wild cats that had appeared in his back yard.
Another pertinent fact for NELA residents: according to the Acute Communicable Disease Control, “Most cases are [found in] residents of central Los Angeles County foothills” although Ramirez has said cases have been reported as far away as Long Beach and Lynwood.
According to Ramirez, in 2011 “there were 39 cases in L.A. county excluding Long Beach and Pasadena.” Ramirez speculates that more cases are being reported due to a combination of “changing weather”--fleas like warmer temperatures--“increased public and physician awareness, and the relocation of opossums and feral cats from endemic to non-endemic areas.”
In case that’s unclear, don't move feral cats, opossums and rats. You’re likely to spread disease.
The Good News
“Endemic typhus differs from epidemic or louse-borne typhus, which does not usually occur in this country,” according to the Department of Public Health.
Murine typhus is also highly treatable with the inexpensive antibiotic “Doxycycline." Paul’s two-week supply cost him just 97 cents. And while some Murine Typhus survivors like Los Angeles Times columnist Meghan Daum report side effects such as a “permanent hearing loss over 6,000 Hz”, Paul ran seven miles on April 1, 2012, the one-year anniversary of his admittance to the ICU.
What to Do
Luckily, serious cases of Murine Typhus are relatively rare. Many people develop antibodies and don’t even know they have it. Paul and Meghan Daum were unlucky. Also, their cases were harder to diagnose because each of them were already very sick by the time they developed the tell-tale rash.
The “takeaway”, as Paul put it, is that he didn’t know about Murine Typhus before he contracted it. The reason he wanted to share his story is so that other people would be aware of the disease, its symptoms, and its causes. “Don’t wait four to five days before going to the doctor,” adds Jill, “and have your loved ones tell the doctor to test for typhus.”
The Department of Public Health also advises L.A. County residents to keep pets, yards and homes free of fleas; eliminate plant debris where infected animals can hide and make sure they can’t nest under crawl spaces; remove outside food sources; and wear protective covering, including “a particle mask or respirator, goggles, and gloves” when cleaning areas where rodents have lodged.
Feeding feral cats in your back yard? Your call.