19th Century Typhus Spreads in Los Angeles
No better barometer exists of shoddy city services and how they affect poor and working-class neighborhoods.
Typhus cases in Los Angeles have reached record levels.
In 2025, 220 cases were reported to the Los Angeles County Public Health Department.
This is directly related to woeful trash collection afflicting numerous city neighborhoods, and the spread of homeless encampments, that I’ve written about here recently.
Typhus is spread by fleas and their feces, which are in turn carried by rats, which feed on uncollected trash.
The disease was present as early as 2016, but first made news in Los Angeles in 2018.
A surge in cases was reported among homeless people in Skid Row, the industrial/warehouse zone east of downtown that has been allowed to become a 60-square block collection of encampments, tents, rampant drug addiction and mental illness, uncollected trash, and hidden within it all, rats who feed on the trash and carry the fleas whose feces spread typhus.
By 2019, cases of typhus had spread to Los Angeles City Hall, not far away.
The latest public health department’s alert is fine. But it leaves out some crucial things about typhus and what its spread says about the city.
Typhus is a disease born in eras before humans invented sewer systems, modern waste management, and anti-bacterial drugs.
It flourishes in cramped, unsanitary conditions.
The “history of typhus is the history of human misery,” wrote a pioneering epidemiologist of the typhus outbreak in 1836 in Philadelphia – one of the country’s first epidemics.
(Typhus is often confused with typhoid, which is an infection of the intestine, caused by consuming contaminated food and water.)
In War and Peace, Russian novelist Leo Tolstoy’s story of the 18th century Napoleonic wars, typhus breaks out among soldiers and prisoners. Charles Dickens included the disease in his novels about urban poverty and blight. Typhus was among a collection of infectious diseases known together as “famine fever” in Ireland in the mid-1800s.
Typhus was one of many killers in Nazi concentration camps. Elie Weisel’s memoir Night and If This Is a Man by Primo Levi each include typhus as part of camp daily life.
During the Nazi blockade of the Warsaw ghetto in Poland in 1940-41, 100,000 Jews were infected with typhus, and 25,000 of them died, according to a Smithsonian magazine report: “German officials knew enough about the spread of typhus to know that by overcrowding, starving and depriving the Jewish residents of basic necessities, the ghetto would become a breeding ground for infection.”
That a disease with such a history would now have settled in a world-class 21st-Century American city ought to be an alarming, front-page story for days.
It ought to be the major issue in this June’s municipal and mayoral elections – the same month, by the way, that the World Cup soccer tournament will attract fans from around the world. Democrats ought to be concerned. Their image is of a party that cannot run cities well. The spread of typhus, of all things, won’t help that.
Per the county public-health department, most typhus cases have broken out in poorer neighborhoods and neighborhoods where trash accumulation and collection are rife: Mid-city, South-Central, Skid Row. But cases have been discovered in Santa Monica, as well.
Uncollected trash and typhus seem to reflect the general municipal dysfunction that wearily afflicts Los Angeles. Roads are potholed, street lights go unrepaired. Rats spread 19th-Century diseases.
Its appearance is recognition of what happens when you ignore the basic services of city government: Poor and working-class people tend the bear the brunt.
This ought to humble members of the L.A. City Council, perhaps prod a reassessment of priorities. After all, if you can’t collect the trash enough to prevent typhus, constituents might reasonably ask, What can you do well?
I’ve been a municipal reporter twice in my journalism career. It always bothers me when I hear people talk about city services as some privileged luxury that concerns only well-off neighborhoods. City services are not a luxury. They are not sexy. They are essential.
When you fail at providing them, everyone eventually suffers, even if the problem started in a neighborhood you would prefer to ignore, like Skid Row.
Those fleas and their feces are proof of that.
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Thank you for this. It’s so tragic, and people don’t realize that the intersecting problems of homelessness, mental illness, and substance use disorder have created a serious public-health problem in LA.
Any explanation as to why the number of cases dropped to 17 this year? Seems to contradict the main point of the article.