Legal Insurrection readers will recall that California, and other areas of the country with a significant homeless population, were hit with an epidemic of Hepatitis A last fall.

This year, Pasadena is reporting an epidemic of flea-borne typhus.

Twenty Pasadena residents have been confirmed to have typhus fever in 2018, a significant increase over past years, according to the city’s health department.

Confirmed cases of the disease, spread to humans by infected fleas, normally number about one to five per year, the agency said Friday. The announcement comes a day after the Los Angeles County Department of Public Health said it is investigating an outbreak of flea-borne typhus among downtown Los Angeles’ homeless population.

Two years ago, L.A. County voters approved a $1.2 billion bond measure to build permanent housing for the homeless. But squalid camps are still popping up everywhere, so temporary shower stations are being opened.

Sadly, the open-arms approach doesn’t seem to be contributing to public health. Downtown Los Angeles is also being impacted by an outbreak of typhus.

An outbreak of flea-borne typhus has hit downtown Los Angeles, the county Department of Public Health said Thursday. Health officials say they are investigating several cases of the disease that infected fleas can spread to humans, CBS Los Angeles reports.

While the fleas can come from cats, rats and opossums, pets and animals do not get sick from typhus.

In people, however, typhus can cause high fever, chills, headache and rash. It is not transmitted from person to person and can be treated with antibiotics.

“Although typhus normally occurs throughout L.A. County, we are observing several cases in the downtown Los Angeles area,” Los Angeles County Health Officer Muntu Davis said in a statement. “We encourage pet owners to practice safe flea control and encourage all cities in the county to ensure maintenance of their trash clean-up and rodent control activities.”

Flea-borne typhus (also called Murine typhus), is a disease caused by a bacteria called Rickettsia typhi. Murine typhus is spread to people through contact with infected fleas. People get sick with murine typhus when infected flea feces are rubbed into cuts or scrapes in the skin. Typhus fever can cause serious complications requiring lengthy hospitalization, and rarely, even death.

The first written recordings of typhus came in 1489 and were associated with the Spanish army’s siege of Granada. High fevers, rashes, delirium, and gangrenous sores were reported; and the disease was routinely associated with warfare thereafter. The term typhus stems from the Greek word typhos, meaning “hazy,” which refers the delirium some develop while infected.

Typhus is now considered to be endemic only in certain areas of the world, including Eastern Africa and a few areas in South and Central America. However, that status might change unless California addresses the trash-filled squalor of its homeless camps more seriously.

Other areas with significant homeless populations may want to prepare for a local typhus outbreak. The Hepatitis A outbreak shows that diseases associated with homeless populations will spread.