Animals Involved
Rats are major reservoir; cats, opossums, possibly dogs, other species in peridomestic cycle
Known Distributions
Worldwide, especially warmer regions
Probable Means of Spreading
Infected rodent fleas, usually via flea feces; cat fleas seem to be involved in some cycles
Clinical Manifestations in People
Fever, severe headache, central rash (not always observed); other signs, including arthralgia, cough, nausea/vomiting in some; mortality rate 4% without treatment