SAN DIEGO — Cases of Rocky Mountain spotted fever increased nearly threefold between 2001 and 2005, John Openshaw reported at the annual meeting of the Infectious Diseases Society of America.
An increase in the number of suburban homes that encroach on rural areas is one possible reason for the spike in reported cases, although “increased physician awareness and increased surveillance efforts are [also] involved,” Mr. Openshaw said during a press briefing. “The true explanation is likely a combination of many factors.”
Rocky Mountain spotted fever is caused by the Rickettsia rickettsii bacteria, which are typically spread through tick bites. Early signs of the fever include acute onset of fever and other flulike symptoms, followed by rash.
“The biggest problem is that people often don't remember being bitten by a tick, and by the time the classic rash appears, the disease has already progressed significantly, and it may be too late,” Dr. David Swerdlow, previous team leader for the rickettsial zoonoses branch of the Centers for Disease Control and Prevention, said in a prepared statement.
Researchers analyzed data from the National Electronic Telecommunications System for Surveillance and found that during 2001–2005, there were 6,598 cases of Rocky Mountain spotted fever reported in 45 states, said Mr. Openshaw, a medical student at the University of Pennsylvania, Philadelphia, who worked on the study during a CDC Applied Epidemiology Fellowship in 2006.
The disease resulted in death in 22 people (0.3%) in that period.
The number of cases in the United States increased nearly threefold over the period, from 695 cases in 2001 to 1,936 cases in 2005. The incidence was higher in suburban areas than it was in rural areas, and the largest increase was in the southern Atlantic states.
Despite the increase in the number of cases, the rates of hospitalization fell from 29% in 2001 to 18% in 2005, and the rates of complications from the disease fell from 8% to 4%.
Immunocompromised patients were most likely to be hospitalized with the disease (41%), followed by adults over the age of 70 years (40%) and children under the age of 5 (35%).
Mr. Openshaw also reported that 53 counties in the United States had a fivefold increase in the incidence of Rocky Mountain spotted fever. Moreover, about half of the 1,079 counties reporting disease were newly affected during the study period.
The disease was reported in every state, except Alaska, California, Hawaii, Maine, and Washington.
“Physicians should be aware of the increase in Rocky Mountain spotted fever,” he said, adding that they should also be aware of “the difficulty in diagnosing a lot of these patients and the importance of proper treatment.”
Physicians should be aware of the difficulty of diagnosing these patients and the importance of proper treatment. MR. OPENSHAW