Typhus pathophysiology

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Pathophysiology

Rickettsial agents are usually not transmissible directly from person to person except by blood transfusion or organ transplantation, although sexual and placental transmission has been proposed for Coxiella.
Transmission generally occurs via an infected arthropod vector or through exposure to an infected animal reservoir host.

Type of Infection	Spread
Epidemic typhus	Body louse
Trench fever	Body louse
Murine typhus	Flea infested rats
Cat flea rickettsioses	Flea infested dogs and cats
Scrub typhus	Mites
Tick borne rickettsiosis	Ticks
Rickettsialpox	Mites
Anaplasmosis	Ixodes tick
Ehrlichiosis	Lone star tick
Q fever	Infected veterinary animals
Cat scratch disease	Infected cats
Oroya fever	Sandflies

Scratching a louse-bite site allows the rickettsia-laden excrement to be inoculated into the bite wound.
Following transmission, rickettsia are ingested by macrophages and polymorphonuclear cells. On ingestion, they replicate intracellularly inside the lysed cells and disseminate systemically.