LOS ANGELES (CBSLA) — Health officials say they are investigating four new cases of flea-borne typhus in the Willowbrook area, a week after announcing an outbreak in Los Angeles County.

With the four new cases, that brings the number of patients in the county so far this year to 63. Health officials earlier this week told the county Board of Supervisors there were a total of 67 cases in 2017.

At least nine of the Los Angeles County cases occurred in downtown Los Angeles, all among homeless people.

County cases do not include those reported in Pasadena and Long Beach. Both cities, which operate their own health departments and compile their own statistics, have also seen a spike in typhus cases.

Pasadena has confirmed 20 cases to date in 2018, compared to a history of one to five cases annually. Long Beach has doubled its usual annual rate with a total of 12 cases reported to date.

Typhus is spread by infected fleas and case symptoms including high fever, chills, headache and rash. In extreme, untreated cases, it can cause death.

The disease is not transmitted from person to person. Health officials say people should protect themselves from flea bites that can protect disease with flea control measures on pets and by using insect repellent. Other recommended measures include keeping garbage cans tightly covered, keep pet food indoors, and keep crawl spaces cleared and blocked to discourage wild and stray animals.

(© Copyright 2018 CBS Broadcasting Inc. All Rights Reserved. City News Service contributed to this report.)

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