Rocky Mountain Spotted Fever

Masters, Edwin J.; Olson, Gary S.; Weiner, Scott J.; Paddock, Christopher D.

doi:10.1001/archinte.163.7.769

Cited by 95 publications

(68 citation statements)

References 63 publications

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“…Doxycycline (200 mg per day) remains the treatment of choice for tick-and flea-transmitted SFG rickettsioses, including in children [60,87,114,117]. In cases of allergy to tetracyclines, chloramphenicol or josamycin (a macrolide not available in the USA) may be administered.…”

Section: Treatmentmentioning

confidence: 99%

Tick- and flea-borne rickettsial emerging zoonoses

2005

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- Between 1984 and2004, nine more species or subspecies of spotted fever rickettsiae were identified as emerging agents of tick-borne rickettsioses throughout the world. Six of these species had first been isolated from ticks and later found to be pathogenic to humans. The most recent example is Rickettsia parkeri, recognized as a human pathogen more than 60 years after its initial isolation from ticks. A new spotted fever rickettsia, R. felis was also found to be associated with fleas and to be a human pathogen. Similarly, bacteria within the family Anaplasmataceae have been considered to be of veterinary importance only, yet three species have been implicated in human diseases in recent years, including Ehrlichia chaffeensis, the agent of human monocytic ehrlichiosis, Anaplasma phagocytophilum, the agent of human anaplasmosis (formerly known as "human granulocytic ehrlichiosis agent", E. equi and E. phagocytophila), and finally Ehrlichia ewingii, which causes granulocytic ehrlichiosis in humans. We present here an overview of the various tick-and flea-borne rickettsial zoonoses described in the last 20 years, focusing on the ecological, epidemiological and clinical aspects.

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Section: Treatmentmentioning

confidence: 99%

Tick- and flea-borne rickettsial emerging zoonoses

2005

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“…8,10,17,26 Es necesario que los médicos consideren FMMR en cualquier niño o adolescente que solicite atención debido a fiebre persistente (≥48 horas) que no responde a los antibióticos convencionales y con una historia de exposición a garrapatas. 15,[28][29][30] Es decir, debe evaluarse cuidadosamente el entorno socioeconómico del paciente y buscar antecedentes que puedan orientar al médico a la sospecha temprana. 8 Aunque idealmente la FMMR debe corroborarse mediante pruebas de laboratorio, su diagnóstico aún se basa en la sospecha clínica, pues la confirmación por IFI es tardía para guiar el manejo médico 31,32 y no debe utilizarse como sustento para iniciar el tratamiento con doxiciclina.…”

Section: Discussionunclassified

Fiebre maculosa de las Montañas Rocosas en niños y adolescentes mexicanos: cuadro clínico y factores de mortalidad

et al. 2016

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Resultados. Se apreció un incremento en la incidencia y mortalidad en los casos hospitalizados por FMMR, con una letalidad de 30%. Tres variables se asociaron con el riesgo de muerte: retraso ≥ 5 días en el inicio del uso de doxiciclina (RM a =2.95, IC95% 1.10-7.95), falla renal aguda (RM a =8.79, IC95% 3.46-22.33) y sepsis severa (RM a =3.71, IC95% 1.44-9.58). Conclusión. La FMMR provoca resultados fatales en niños, que puede evitarse con la administración oportuna de doxiciclina. La falla renal aguda y la sepsis severa son dos predictores de muerte en niños con FMMR. Results. An upward trend was observed in RMSF morbidity and mortality. Fatality rate was 30%. Three predictors were associated with risk of death: delay ≥ 5 days at the start of doxycycline (OR a = 2.95, 95% CI 1.10-7.95), acute renal failure ((OR a = 8.79, 95% CI 3.46-22.33) and severe sepsis (OR a = 3.71, 95% CI 1.44-9.58). Conclusions. RMSF causes high mortality in children, which can be avoided with timely initiation of doxycycline. Acute renal failure and severe sepsis are two independent predictors of death in children with RMSF.

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“…Therefore, it is plausible that suitable habitat features are overlapping for the tick vectors [39]. Another possible reason for this interaction is that both diseases have similar clinical presentations; thus cases may be misdiagnosed between the two diseases [40]. In highly endemic areas within the US where awareness of RMSF is high, many patients receive an alternate diagnosis when initially seeking medical attention.…”

Section: Discussionmentioning

confidence: 99%

Spatially Explicit Nonlinear Models for Explaining the Occurrence of Infectious Zoonotic Diseases

Jones¹,

Conner

Song

2012

ISRN Biomathematics

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Zoonotic diseases can be transmitted via an arthropod vector, and disease risk maps are often created based on underlying associative factors within the surrounding landscape of known occurrences. A limitation however is the ability to map disease risk at a meaningful geographic scale, and traditional regression modeling approaches may not always be appropriate. Our objective was to determine if nonlinear modeling could improve explanatory power in describing the occurrence of 2 tick-borne diseases (Lyme disease (LD) and Rocky Mountain spotted fever (RMSF)) known to occur in Tennessee. Medically diagnosed cases of LD (ICD-9: 088.81) and RMSF (ICD-9: 082.0) were extracted from a managed care organization data warehouse for the 2000-2009 time period. Four separate modeling techniques were constructed (logistic regression, classification and regression tree (CART), gradient boosted tree (GBT), and neural network (NNET)) and compared for accuracy. Results suggest that areas higher in disease prevalence were not necessarily the same areas having high predicted disease risk. GBT best explained LD occurrence (misclassification rate: 0.232; ROC: 0.789). RMSF prevalence was best explained with an NNET algorithm (misclassification rate: 0.288; ROC: 0.696). Covariates explaining disease risk included forested wetlands, urbanization, and median income. Nonlinear modeling may provide better results than traditional regression-based approaches.

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Rocky Mountain Spotted Fever

Cited by 95 publications

References 63 publications

Tick- and flea-borne rickettsial emerging zoonoses

Tick- and flea-borne rickettsial emerging zoonoses

Fiebre maculosa de las Montañas Rocosas en niños y adolescentes mexicanos: cuadro clínico y factores de mortalidad

Spatially Explicit Nonlinear Models for Explaining the Occurrence of Infectious Zoonotic Diseases

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