Rocky Mountain Spotted Fever in a Large Metropolitan Center,Mexico–United States Border, 2009–2019 |
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| Authors: | Oscar E Zazueta Paige A Armstrong Adriana Mrquez-Elguea Nstor Saúl Hernndez Miln Amy E Peterson Diego F Ovalle-Marroquín Maria Fierro Rodolfo Arroyo-Machado Moises Rodriguez-Lomeli Guillermo Trejo-Dozal Christopher D Paddock |
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| Institution: | Secretariat of Health of Baja California (Instituto de Servicios de Salud Pública del Estado de Baja California), Mexicali, Mexico (O.E. Zazueta, A. Márquez-Elguea, N.S.H. Milán, D.F. Ovalle-Marroquín, R. Arroyo-Machado, M. Rodriguez-Lomeli, G. Trejo-Dozal);Centers for Disease Control and Prevention, Atlanta, Georgia, USA (P.A. Armstrong, A.E. Peterson, C.D. Paddock);Imperial Country Public Health Department, El Centro, California, USA (M. Fierro) |
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| Abstract: | Epidemic levels of Rocky Mountain spotted fever (RMSF) have persisted in Mexicali, Mexico, since the initial outbreak was first reported in December 2008. We compared clinical and epidemiologic data of cases in Mexicali during 2009–2019 between patients with an IgG titer reactive with Rickettsia rickettsii bacteria by indirect immunofluorescence antibody (IFA) assay and those who demonstrated DNA of R. rickettsii in a whole blood sample when tested by PCR. We identified 4,290 patients with clinical and epidemiologic features compatible with RMSF; of these, 9.74% tested positive by IFA and 8.41% by PCR. Overall, 140 patients died (11-year case-fatality rate 17.97%). Substantial differences in the frequency of commonly recognized clinical characteristics of RMSF were identified between PCR-positive and IFA-positive cases. The Mexicali epidemic is unique in its size and urban centralization. Cases confirmed by PCR most accurately reflect the clinical profile of RMSF. |
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| Keywords: | Rocky Mountain spotted fever Rhipicephalus sanguineus Rickettsia rickettsii tickborne diseases zoonoses epidemiology Mexico Mexicali bacteria bacterial infections rickettsial diseases United States vector-borne infections |
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