Haverhill Fever

Haverhill fever—also known as rat-bite fever, sodoku, streptobacillary fever, streptobacillosis, spirillary fever, and epidemic arthritic erythema—is an infection that usually results from handling or being bitten by an infected rat, although outbreaks have also been associated with ingestion of milk or water contaminated with rat urine or feces. Haverhill fever is not a notifiable disease in the United States, so its exact incidence is not known. It is found worldwide but is uncommon in North and South America and most of Europe.

Causes

Haverhill fever is caused by Actinobacillus muris (formerly known as Streptobacillus moniliformis) and Spirillum minus. People at risk for contracting this infection include animal handlers and veterinarians, people who have pet rodents, and people living in rat-infested dwellings. Haverhill fever is not transmitted from person to person. More often, it is transmitted through contact with the urine or secretions from the mouth, eyes, or nose of an infected animal. Besides rats, other rodents that may transmit the infection include mice, squirrels, gerbils, and weasels.

Complications

Complications of Haverhill fever include endocarditis, pericarditis, and meningitis. Abscesses of the brain or soft tissue, parotitis, and tenosynovitis may also occur. Mortality can be as high as 13% without appropriate treatment.

Assessment Findings

Signs and symptoms of Haverhill fever begin 2 to 10 days after exposure. Symptoms are flu-like, including chills and fever (101° to 104° F or 38.3° to 40° C), muscle aches, and sore throat. Joints may become red, swollen, and painful. (See Causes, signs, and symptoms of Haverhill fever.) A rash often occurs on the hands and feet within 2 to 4 days. If infection is with S. minus, an open-crusted sore may form around the area of a rat bite. This form of Haverhill fever is called sodoku.

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