Rocky Mountain Spotted Fever — Changing Ecology and Persisting Virulence

Abstract
The explosive growth of emerging infections during the past 20 years has made it difficult to issue a call to arms about any pathogen with ecologic and epidemiologic features that are not conducive to a risk of dramatic regional or global spread. Such is the case with Rocky Mountain spotted fever, which is still one of the most virulent human infections ever identified. Nearly 100 years have elapsed since Howard T. Ricketts first described the pathogen transmitted by Montana ticks that killed up to 75 percent of the patients it infected. Despite a century of study, the causative bacterial agent . . .

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