Oct. 10, 2018 -- Public health officials in Los Angeles are still working to control an outbreak of typhus, a bacterial disease spread by infected fleas, in the downtown area and elsewhere in the sprawling county.

From mid-July until early October, nine cases of typhus have been observed in the downtown area alone, says Sharon Balter, MD, director of the division of communicable disease for the L.A. County Department of Public Health. Downtown Los Angeles has a large population of homeless people, and while all nine patients have a history of living or working in downtown L.A., not all those affected are homeless, she says.

"Homelessness, crowded housing, poor hygiene, poor toiletry habits” all make it more likely to get typhus, says Aaron Glatt, MD, chairman of medicine and hospital epidemiologist for South Nassau Communities Hospital, Oceanside, NY.

While typhus is normally seen throughout the county, that number of cases is unusually high in such a short period of time, she says. From January until early October, 59 cases have been documented. "In 2017, there were 67 cases for the whole year," Balter says. "So if we continue [seeing cases], we might exceed the number from last year."

Nearby, Pasadena has reported an additional 20 cases of typhus, up to four times as many as the city typically sees each year.

Typhus is “easily treated with antibiotics," Balter says. "But people can become very sick if they don't get prompt treatment."