MARY LOUISE KELLY, HOST:
Typhus is a disease many thought was a thing of the past. Now, it's making a comeback. Health officials are reporting a rise in cases, especially in Texas. As Texas Public Radio's David Martin Davies reports, it's taken many by surprise.
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DAVID MARTIN DAVIES, BYLINE: When Dana Clark plays her antique parlor organ these days, it takes extra effort. While vigorously driving the foot bellows, she fingers the black and white keys.
DANA CLARK: My great-grandmother's pump organ - it's a hundred and twenty years old.
DAVIES: In May, 76-year-old Clark contracted typhus from clearing weeds from her garden.
CLARK: I created a lot of dust, and just inhaling that dust can give someone typhus because flea excrement.
DAVIES: Days after exposure, symptoms often begin with high fever, headache and body aches. A rash can also appear, according to the Centers for Disease Control and Prevention. When treated promptly with antibiotics, outcomes are usually good. But delayed diagnosis increases the risk of complications and hospitalization. That's what happened to Clark.
GREGORY ANSTEAD: It's still not an extremely well-known disease.
DAVIES: Dr. Gregory Anstead is a San Antonio-based infectious disease specialist. He has conducted extensive research into the resurgence of flea-borne typhus in Texas.
ANSTEAD: In the 1990s, there were only about 200 cases in the state of Texas. 2010 to 2019, the number of cases went up 12-fold.
DAVIES: The number of typhus cases is climbing in Texas, California and Hawaii. In Los Angeles County, for example, typhus cases rose from 31 in 2010 to 171 in 2022. Because the disease had been so rare, the CDC doesn't track typhus cases, but historically, it was a common scourge. In the 1940s, it was so widespread in San Antonio that the city was used as an experiment.
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UNIDENTIFIED REPORTER: Health authorities of the city of San Antonio, Texas, attacked the germ carrier throughout the city.
ANSTEAD: The U.S. Public Health Service took, you know, several tons of DDT. They spread it to 22,000 rooms in urban San Antonio.
DAVIES: This citywide anti-typhus blitz worked. The number of typhus cases dropped, and the war against typhus fleas and rats spread across the South.
ANSTEAD: The combination of insecticide treatment with DDT and also spreading these new rodenticides, you know, definitely interrupted this transmission cycle of typhus.
DAVIES: But now typhus is back. Climate change is creating better conditions for the malady. Fleas and typhus bacteria thrive in the warmer temperatures. Rat populations are also booming due to a warming climate. A study recently published in Science Advances finds rat numbers are up in cities, including Washington, D.C., and New York, all of which fuels transmission.
CLARK: It's been a long ordeal.
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DAVIES: Clark is back to playing the piano and giving music lessons. She recommends people wear an N95 mask while pulling weeds to avoid breathing in typhus-infected dust.
For NPR News, I'm David Martin Davies in San Antonio. Transcript provided by NPR, Copyright NPR.
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