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Murine typhus has been reemerging in southeastern Mexico for the past 6 years (3, 7 ).
However, murine typhus has been a reportable disease in Texas for the past 40 years.
Murine typhus has never been reported in Japan after the 1950s, except for the three suspected cases and this case.
Recently, murine typhus has been shown to exist in some endemic foci where neither rats or their fleas are found.
A relatively low frequency of lymphadenopathy in patients with murine typhus has been described from Crete (4% [ 22]), Texas (16% of children [ 23]), and Spain (2% [ 24]).
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In addition, none of our patients with murine typhus had positive blood cultures.
At the end of 2009, a total of 47 cases of murine typhus had been recorded in New Zealand.
On the Canary Islands Atlanticc islands of Spain), autochthonous cases of murine typhus have been reported (9 ).
Patients with murine typhus had a lower frequency of peripheral lymphadenopathy than those with scrub typhus (3% vs. 46%, p<0.001).
28, 29 Histopathological changes in the liver of patients with scrub and murine typhus have been identified in case reports.
Sporadic outbreaks of murine typhus have been reported in Australia and more recently in China, Greece, Israel, Kuwait, and Thailand (4 – 6 ).
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