Endemic typhus is caused by R. typhi. These bacteria are transmitted by the Oriental rat flea, an insect that lives on small rodents. Endemic typhus (sometimes called murine typhus or rat-flea typhus) is found worldwide. The symptoms of endemic typhus are mild compared to those of epidemic typhus. In fact, many people do not seek treatment for their symptoms, as the rash that accompanies the disease may be short-lived. Deaths from endemic typhus have been documented, however; these deaths usually occur in the elderly and in people who are already sick with other diseases.