Murine (Endemic) Typhus (Rat-Flea Typhus; Urban Typhus of Malaya) By William A Petri, Jr, MD, PhD, University of Virginia School of Medicine Reviewed / Revised Mar 2022 | Modified Sep 2022 View Patient Education Symptoms and Signs Diagnosis Treatment Prevention Key Points Murine typhus is caused by Rickettsia typhi and R felis, which are transmitted to humans by fleas; it is clinically similar to but milder than epidemic typhus, causing chills, headache, fever, and rash.