| Summary: | Murine typhus and “murine-typhus-like ” disease are reemerging infectious diseases. In Canary Islands (Spain), a rather distinct clinical pattern characterized by higher incidence of complications, especially renal damage (including acute failure and urinalysis abnormalities), is apparent and highly suggestive. It could be related to different strains of Rickettsia typhi or other cross-reactive species. The Study Murine or endemic typhus is caused by Rickettsia typhi, formerly R. mooseri (1). Classic murine typhus is a zoonosis maintained in rats (Rattus rattus and Rattus norvergicus) and transmitted to humans through damaged skin by infected feces from the oriental rat flea (Xenopsylla cheopis) (2). New patterns of disease (“murine typhuslike” disease) have been described in recent years, and a new species of Rickettsia (R. felis) that causes a similar clinical picture has been identified (1–3). New modes of infection have been identified, including infection through inhalation of flea feces and transmission by different types of fleas (Ctenophtephalis felis) and from different reservoirs (e.g., dog, cat, and opossum). Murine typhus occurs worldwide, particularly in warm and humid climates (1). In Spain, two seroepidemiologic surveys, in Salamanca and Madrid (Central/Western Spain), yielded seroprevalence rates of 12.8 % and 68%, respectively, in the general population (4,5). However, no clinical cases have been reported. In Seville (Southwestern Spain), murine typhus is an important cause of fever of intermediate duration (6), and in Canary Islands, 10 autochthonous cases have been reported from Tenerife (7). For this reason, we include serologic testing for R. typhi in
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