A Texas man has had both his hands and parts of his feet amputated after catching typhus from a flea.
Michael Kohlhof from Houston was visiting his mother in hospital in San Antonio when he fell ill on June 19 – with what his family suspected was the flu.
The 35-year-old was immediately rushed to the ICU suffering from sepsis and organ failure that was so severe his family was told he would likely die.
But the handyman and pet sitter miraculously pulled through, yet remains in hospital with multiple further surgeries expected.
Michael Kohlhof is pictured in hospital, where he was admitted on June 19. He has multiple surgeries ahead of him, and no health insurance
A handyman, pet sitter and artist, Kohlhof has lost his arms up to his forearm; his toes, and parts of his feet
Michael Kohlhof, 35, from Houston, was bitten by a flea and developed typhus
Typhus: Killer bacteria passed on by fleas that wreak havoc across California, Texas and Hawaii
Typhus is a bacterial disease that causes fever, headache, rash, muscle ache, and fever and chills. In severe cases, patients can require hospitalization due to hepatitis or internal bleeding.
It is caused by the bacteria Rickettsia typhi and possibly Rickettsia felis, which are carried by fleas, lice, mites or ticks. The pests live on animals, particularly feral and stray cats, rats and opossums, but do not make their host animals unwell.
Flea-borne typhus is endemic in parts of LA and Orange County. The disease also often occurs in Texas and Hawaii.
Around 200 cases occur every year throughout the US, particularly in coastal regions. Bacteria spread when faeces from an infected insect contaminate a person’s cut or graze while the insect is sucking their blood.
If the person scratches the bite area, the bacteria from the faeces can enter their bloodstream. Bacteria can also be rubbed into a person’s eyes, or, in rare cases, inhaled.
Symptoms then appear six-to-14 days later. Typhus can be treated via antibiotics, with most people recovering within a few days.
Between two and four per cent of people who do not receive treatment die worldwide. Typhus can be prevented by avoiding contact with fleas, mites, ticks and lice.
‘He almost died once or twice,’ said his brother, Greg Kohlhof. ‘They were worried about him being brain dead.’
Kohlhof did not show any abnormal symptoms in the weeks leading up to his diagnosis, although he felt tired.
Symptoms of typhus include fever and chills, body aches and muscle pain, loss of appetite, and vomiting, according to the CDC.
‘Untreated, typhus can cause severe illness and damage to one or more organs, including the liver, kidneys, heart, lungs, and brain,’ the CDC says.
Greg told KENS5 that Michael was fortunate to be visiting his mother at the time. ‘With his symptoms being so general, I don’t know if he would have went to the doctor. He would have probably just tried to sleep it off.’
J’Lenne Hardaway, Kohlhof’s mother, said doctors told them this type of flea is only found in California and Texas.
They said he was ‘the victim of a severe and traumatic bite from one single flea — with unimaginable consequences,’ she said on a GoFundMe page.
Her son did not have health insurance, and she is now fundraising to help him. ‘If it were 48 hours later, he would have not made it,’ she said.
Greg said he was impressed with his brother’s resilience. ‘How he is right now, I’m just amazed,’ he said. He also told how his brother loved to be creative.
‘Me and him talked about it. It’s not your hands that do all these great things. It’s your mind,’ Greg said he told his brother.
‘You’ll just have to find a new avenue to exercise it.’ He said Michael hopes people learn from his experience.
‘I think he also wants people to know this kind of stuff is out there,’ said Greg. ‘There are fleas, there are diseases, but just be cautious, be aware, don’t be afraid to live your life.’
Alishpa Masood, Michael’s girlfriend, told KHOU 11: ‘He has gone beyond our expectations as far as strength and bravery. ‘He has a really positive outlook that we’re all really proud of.’
Michael Kohlhof’s mother J’Lenne Hardaway, and his brother Greg, said they were lucky he survived
Flea-borne typhus has been rampant across the West Coast in recent years, with Lose Angeles and Long Beach hit hard in 2018.
Officials recorded 12 cases of the bug in Long Beach, home to 470,000 people and around 20 miles south of downtown LA.
Many of the cases were among homeless people and it was feared the disease was being spread by rats and feral cats.
A further 20 cases were recorded in Pasadena – and 59 in the whole of LA County in total.
Pasadena and Long Beach are both technically in LA County, but they have their own health departments which record their own figures.
Flea-borne typhus occurs when feces from an infected insect come into contact with a person’s cut or gets rubbed into their eyes.
These fleas often live on feral cats and rats who are attracted to areas with trash on the streets.
The 2018 flea-borne typhus outbreak in LA County was unusually severe. Just 67 cases were recorded in the whole of 2017.
Flea-borne typhus occurs when faeces from an infected insect come into contact with a person’s cut or gets rubbed into their eyes. The insects often live on feral cats and rats (file photo)
Pasadena and Long Beach have an average of five or six per year. Officials could not explain why typhus was hitting the three cities so hard.
Symptoms of typhus in humans include fever, chills, headaches, rashes and muscle ache.
In rare cases, the infection can cause liver failure or be fatal – an estimated two to four per cent of untreated patients die.
Typhus usually affects around 200 people across the US every year, according to the California Department of Public Health (CDPH).
Health officials were alerted to the outbreak when a cluster of nine cases occurred in downtown LA between July and August.
The infection is endemic – commonly found – in parts of LA and Orange County, Southern California.
Fleas carrying the infection can live on cats, rats or opossums, however, the animals themselves do not suffer symptoms.
Typhus often spreads in areas where there is an accumulation of trash that attracts wild animals.
The infection cannot be transmitted from person-to-person and is treatable with antibiotics. There is no vaccine in the US.
Up to four per cent of people worldwide who are untreated die, the CDPH claims.
To prevent infection, LA’s public health department recommends residents: use flea control on pets, tuck their pants into their socks or boots when outside and avoid wild or stray animals.
Texas has also experienced a flea-borne typhus outbreak previously.