Surveillance of Rocky Mountain Spotted Fever in the United States, 1981-1983

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Abstract
Surveillance of Rocky Mountain spotted fever (RMSF) in the United States has revealed a stable incidence of the disease from 1981 to 1983, with a median of 0.48 cases/100,OOO population per year (range, 0.42–0.52). During this three-year period an increase in both the number and the percentage of total cases reported from the West South Central states was observed when compared with previous three-year periods. An expanded case report form, which was introduced in 1981 for use by state health departments, was received for 2,850 (87%) of the 3,294 cases reported in 1981–1983. Of these 2850 cases, 1375 (48%) were laboratory confirmed. Death from RMSF was more common in persons ⩾30 years of age (case-fatality ratio of 8.4%) than in persons P < .001). Fatality was also associated with failure to obtain a history of a tick bite within 14 days before onset of illness (P <.05) and with lack of treatment with tetracycline or chloramphenicol (P < .01).

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