Medieval Diseases Have Returned To Los Angeles

In what can only be described as a stunning failure of state and local policy and leadership, Los Angeles County recorded its highest tally of flea-borne typhus cases in 2025, confirming 220 diagnoses, up from 187 the year before, according to the county's Department of Public Health. Almost nine in ten of those patients ended up hospitalized. Fleas that feed on infected rats, opossums, and other small mammals carry the bacteria behind the disease to humans, and Los Angeles has watched the case count climb for years. The 2025 total marks the sharpest jump yet.

Dr. Dean Winslow has practiced infectious disease medicine for fifty years. He taught at Stanford, ran COVID-19 testing programs for the federal government, and served as President Trump's 2017 nominee for assistant secretary of defense for health affairs. Asked whether a typhus outbreak in one of the wealthiest counties in America points to a broader failure in public health and sanitation, Winslow gave a one-word answer. "Absolutely," he told the Daily Signal.

"It's largely an issue of ... people living in just horrible conditions in close proximity to rats," Winslow said, naming rodents as the primary vector for the infection's spread.

The conditions track with the county's homelessness numbers. Homelessness in LA County rose 3.3% over the past year, and in the city of Los Angeles itself the figure climbed 7.9%, according to data from the Los Angeles Homeless Services Authority. Winslow said encampments put residents at heightened risk given their proximity to rats, though he cautioned the problem extends beyond encampments alone.

Asked what he would tell city officials, Winslow said the priority should be to "get a handle again on rat control issues."

That task has gotten harder since 2020, when Gov. Gavin Newsom signed Assembly Bill 1788 into law, restricting the use of four rodenticides over concerns about their effects on mountain lions and other wildlife. Winslow pointed to the restrictions as one likely culprit behind the county's swelling rat population, since pest-control operators have shifted toward traps and less potent methods in response. "Those may be two reasons why ... the rat population is out of control [in LA]," he said.

The county's own public health guidance seems to put the burden of prevention on residents, telling them to keep pets on flea-control products, avoid stray animals, clear yard debris, secure trash in tightly lidded containers, and report rodents or opossums to animal control. Mayor Karen Bass's office did not respond to the Daily Signal's request for comment.

Christopher Rufo, a senior fellow at the Manhattan Institute, examined the county's internal records for City Journal. His team filed public records requests and received a thousand pages of documents from the county health department. What those documents showed is a public health system bracing for outbreaks it had fallen behind on.

"This is about plague rats that have returned," Rufo told Hugh Hewitt on the Salem News Channel. "So we did a story, we did FOIA, we got 1,000 pages of documents from the County Health Department in Los Angeles. And the picture that these documents painted was quite grim. 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."

Rufo laid out two forces behind the outbreak. "And there are a couple of causes for this. The first is that the homeless encampments that are scattered, not just in Skid Row, but throughout the city, are the perfect breeding ground for rats. And so now there are millions of rats breeding under the streets of Los Angeles. And the County Health Department admits in these internal documents that they're not ready for these outbreaks," he continued. "And at the same time, you have California Governor Gavin Newsom in two separate pieces of legislation in recent years banning all of the most effective rodenticides, so rat poisons that can keep that population at bay. And when you put those ingredients together, you get something that experts predicted in LA seems powerless to stop, which is typhus, including three deaths from typhus in recent years."

.@christopherrufo: "You have a return of typhus. You have outbreaks of hantavirus. You have a plethora of medieval diseases that are on the rise in L.A.

There are a couple of causes for this. The first is that the homeless encampments that are scattered, not just in Skid Row,… pic.twitter.com/bam0xbUkPb

— Manhattan Institute (@ManhattanInst) August 18, 2026

Three deaths and 220 hospitalization cases in a single year mark a policy failure in a county that absolutely has the resources to prevent it. Encampments stayed in place. Rodenticides came off the shelf. The health department knew what was coming and clearly could not (or would not) stop it. State and local officials built, permitted, and, in some cases, legislated the conditions that allowed the rat population to multiply beneath the streets of one of the wealthiest cities in America.