Los Angeles County logged 220 diagnoses of flea-borne typhus in 2025. That was up from 187 the year before. Nearly 90% of those patients were hospitalized. Three died.
Flea-borne typhus. In the second-largest city in America. In the twenty-first century.
The numbers come from a review of over 1,000 pages of Los Angeles County Department of Public Health documents. The disease — spread by fleas that ride on rats and opossums — was supposed to be a relic of conditions we solved generations ago with basic sanitation, pest control, and functioning municipal governance. Los Angeles has managed to un-solve all three.
Dr. Dean Winslow, a Stanford infectious disease physician with 50 years in the field and a 2017 Trump nominee for assistant secretary of defense for health affairs, confirmed what the data already screams. Asked whether this constitutes a public health and sanitation failure, Winslow said "absolutely." He pointed directly at the root cause: "It's largely an issue of people living in just horrible conditions in close proximity to rats."
The rat problem isn't an accident. In 2020, Governor Gavin Newsom signed Assembly Bill 1788, which restricted four rodenticide products used for pest control. Winslow connected the dots: "Those may be two reasons why the rat population is out of control" in Los Angeles. The state literally banned the tools cities use to kill rats, and now the rats are spreading medieval diseases. Winslow's prescription is straightforward — "get a handle again on rat control issues." Groundbreaking stuff.
But typhus isn't the only visitor from the Middle Ages making a comeback on Skid Row. Christopher Rufo, senior fellow at the Manhattan Institute, laid it out on Salem News Channel with Hugh Hewitt: "You have a return of typhus, you have outbreaks of hantavirus, you have really a plethora of medieval diseases that are on the rise in LA." His summary was blunt: "This is about plague rats that have returned."
The conditions fueling the outbreak aren't improving. The Los Angeles Homeless Services Authority's own data shows homelessness in Los Angeles city climbed 7.9% over the past year. Across LA County, the increase was 3.3%. More people living on streets with no sanitation means more rats, more fleas, and more disease. This isn't complicated epidemiology. It's cause and effect that a medieval peasant would have understood.
Mayor Karen Bass has presided over a city where the homeless population is growing, the rat population is thriving, and diseases that peaked during the reign of Edward III are making statistical comebacks. The progressive governance model in Los Angeles has had every advantage — supermajority political control, massive budgets, a cooperative state government in Sacramento — and it produced typhus.
Other cities manage to keep flea-borne typhus at zero. Los Angeles can't keep it under 220. The difference isn't geography or climate or bad luck. It's policy — specifically, decades of policy that treats sanitation, law enforcement, and pest control as lower priorities than ideological signaling.
The Black Death killed roughly a third of Europe. Nobody's suggesting Los Angeles is headed there. But when your city is producing diseases that belong in a history textbook, the question isn't whether your governance model failed. It's how many more pages of public health documents it takes before someone admits it.