S2E15 Scratching the Surface: How We Miss Murine Typhus

Murine typhus is a flea-borne bacterial infection that continues to circulate in parts of the United States, particularly in urban and suburban environments. But it’s often missed—because its symptoms are nonspecific, its rash may be subtle or absent, and it doesn’t fit the diagnostic patterns clinicians expect.

In this episode, we explore:

• How murine typhus is transmitted (and why fleas matter more than you think)
• The role of urban ecology, including opossums, rodents, and flea vectors
• What happens biologically when Rickettsia typhi infects endothelial cells
• Why these infections are frequently misdiagnosed or overlooked

This is not just an episode about typhus—it’s about how recognition fails, and what that means for the diseases hiding in plain sight.

Also in this episode, introducing Field Notes, the new, free email newsletter companion to the episodes - not a recap, but what stays with Heather after the episodes. Issues are sent mid-morning after episodes drop.

Sign up on the website if you want to receive Field Notes. 

Companion blog post with transcript and all citations is at infectiousdose.com