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Flea Bites on Humans

Flea bites (from dog, cat and human fleas) are second to mosquito bites as the most common cause of insect bites in children. They usually occur from spring to fall, although if cats and dogs are in the house they can occur all year long. Fleas can live in carpeting for long periods of time. Flea bites usually occur on exposed parts of the body.

Flea bites cause intense itching. Treatment centers around control of the itching. Oral antihistamines, calamine lotion, or topical steroids give only temporary relief. Cool compresses may also be used. Topical antihistamines should not be used for insect bites as they are potent sensitizers and may worsen the situation. If fleas are present in the home, the home should be treated to rid it of the insects. Animals should also be treated.

There are 2 infections that can be passed from fleas to humans. Murine typhus and plague. Murine typhus is an infection of rats and is passed from rat to rat by rat fleas. On occasion an infected flea will bite a human if rats are not available to feed on. This disease is prevalent in coastal areas and around granaries (grain storehouses). There are about 60 to 80 cases per year in the U.S. The symptoms are headache, fever and rash. Complications are uncommon. Treatment is with tetracycline. Eradication of rats is the principal means of preventing the spread of this infection to humans.

Plague is the second infectious illness that can be caused by the bite of a rat flea. It is responsible for the most devastating epidemics in history. The plague in Europe during the mid-1300s, called the Black Death, killed 1/3 of the population of Europe.

Plague can also be transmitted by contact with respiratory droplets of an infected person or animal. Plague is caused by the bacterium Yersinia pestis. Plague occurs in many parts of the world. In the U.S. it has been reported in New Mexico, Arizona, California, and Colorado. It is usually seen in rural settings associated with infected ground squirrels, prairie dogs, and other wild rodents. Children should be educated about the importance of avoiding contact with sick and dead animals. Plague can manifest clinically in several forms: bubonic plague (enlarged, painful lymph nodes) and pneumonic plague (cough, fever, bloody sputum). All cases are characterized by fever, chills, headache, and rapidly progressive weakness. Treatment should be started immediately with antibiotics. Untreated plague has mortality rates between 40 and 70%.

A vaccine exists for people who have occupations that place them at high risk such as field biologists and laboratory workers. This vaccine is only approved for people age 18 years and older.