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The typhus rats: Why a medieval disease is rocking LA

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Rats, and the fleas that live on them, can be carriers of deadly diseases — including typhus, a bacteria-borne, fever-like illness that is rocking LA.

Since 2009, the number of flea-borne typhus cases in LA has increased by a staggering 2,300%. Last year, the county recorded more cases than at any point in its history. Some patients have died. Behind the scenes, the authorities responsible for protecting the public admit that they lack the resources they need to get the situation under control. 

The rats, meantime, spread disease in predictable ways. They feed on trash, fleas feed on those rats, and the infected fleas bite people, who in turn suffer anything from a mild illness treatable with antibiotics to a sickness that ends in death. 

Crumbling infrastructure, a homelessness crisis, garbage-ridden streets, ineffective rodent control, and state restrictions on popular rodenticides have combined to enable the spread of a medieval disease.

Whether you see them or merely pass by as they furrow in the dark, one thing is clear: In LA, the rats are everywhere.

In 2018, it was clear that LA had a serious problem. For much of the early 2000s, the county recorded just a handful of flea-borne typhus cases each year; in 2009, for example, it saw just nine.

But in 2018, LA battled multiple localized typhus outbreaks, marking a watershed moment for public health officials in the county. 

The outbreaks started in the summer. Between July and September, the county identified nine typhus cases linked to downtown. All of them required hospitalization, and six of the nine sufferers had either been homeless or lived in transitional housing. By year’s end, LA had recorded 109 cases of typhus countywide — a record high. 

The situation that year was so bad that the city government couldn’t even keep its own employees safe. At the time, Elizabeth Greenwood was a deputy city attorney. One day at work, Greenwood said her shin began to hurt. When she inspected her leg, she noticed some small insect bites but thought nothing of it. Within weeks, Greenwood was reportedly “gravely ill” and suffering from a severe headache, dizziness so bad she couldn’t walk to the........

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