The emergence of Rocky Mountain spotted fever in the southwestern United States and northern Mexico requires a binational One Health approach in: Journal of the American Veterinary Medical Association Volume 262 Issue 5 (2024)

The emergence of Rocky Mountain spotted fever in the southwestern United States and northern Mexico requires a binational One Health approach

Janet Foley School of Veterinary Medicine, Department of Medicine and Epidemiology, University of California-Davis, Davis, CA

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Gerardo Álvarez-Hernández Department of Medicine and Health Sciences, University of Sonora, Hermosillo, Mexico

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Laura H. Backus School of Veterinary Medicine, Department of Medicine and Epidemiology, University of California-Davis, Davis, CA

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Anne Kjemtrup Vector-Borne Disease Section, California Department of Health Services, Sacramento, CA

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Andrés M. Lopéz-Pérez School of Veterinary Medicine, Department of Medicine and Epidemiology, University of California-Davis, Davis, CA
Red de Biología y Conservación de Vertebrados, Instituto de Ecología, Veracruz, Mexico

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Christopher D. Paddock Rickettsial Zoonoses Branch, CDC, Atlanta, GA

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Francesca Rubino School of Veterinary Medicine, Department of Medicine and Epidemiology, University of California-Davis, Davis, CA

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Oscar E. Zazueta Departamento de Epidemiología, Instituto de Servicios de Salud Pública del Estado de Baja California, Mexicali, Mexico

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Abstract

Rocky Mountain spotted fever (RMSF) is an international and quintessential One Health problem. This paper synthesizes recent knowledge in One Health, binational RMSF concerns, and veterinary and human medical perspectives to this fatal, reemerging problem.

RMSF, a life-threatening tick-borne disease caused by the bacterium Rickettsia rickettsii, emerged during the first decade of the 21st century in impoverished communities in the southwestern US and northern Mexico. Lack of an index of suspicion, delay in diagnosis, and delayed initiation of antibiotic treatment contribute to fatality. Campaigns targeting dog neutering, restraint to residents’ properties, and on-dog and on-premises treatment with acaricides temporarily reduce prevalence but are often untenable economically. Contemporary Mexican RMSF is hyperendemic in small communities and cities, whereas epidemics occur in the western US primarily in small tribal communities. In in both locations, the epidemics are fueled by free-roaming dogs and massive brown dog tick populations. In the US, RMSF has a case fatality rate of 5% to 7%; among thousands of annual cases in Mexico, case fatality often exceeds 30%., Numerous case patients in US border states have recent travel histories to northern Mexico.

Veterinarians and physicians should alert the public to RMSF risk, methods of prevention, and the importance of urgent treatment with doxycycline if symptomatic. One Health professionals contribute ideas to manage ticks and rickettsial disease and provide broad education for the public and medical professionals. Novel management approaches include vaccine development and deployment, acaricide resistance monitoring, and modeling to guide targeted dog population management and other interventions.

Abstract

Rocky Mountain spotted fever (RMSF) is an international and quintessential One Health problem. This paper synthesizes recent knowledge in One Health, binational RMSF concerns, and veterinary and human medical perspectives to this fatal, reemerging problem.

RMSF, a life-threatening tick-borne disease caused by the bacterium Rickettsia rickettsii, emerged during the first decade of the 21st century in impoverished communities in the southwestern US and northern Mexico. Lack of an index of suspicion, delay in diagnosis, and delayed initiation of antibiotic treatment contribute to fatality. Campaigns targeting dog neutering, restraint to residents’ properties, and on-dog and on-premises treatment with acaricides temporarily reduce prevalence but are often untenable economically. Contemporary Mexican RMSF is hyperendemic in small communities and cities, whereas epidemics occur in the western US primarily in small tribal communities. In in both locations, the epidemics are fueled by free-roaming dogs and massive brown dog tick populations. In the US, RMSF has a case fatality rate of 5% to 7%; among thousands of annual cases in Mexico, case fatality often exceeds 30%., Numerous case patients in US border states have recent travel histories to northern Mexico.

Veterinarians and physicians should alert the public to RMSF risk, methods of prevention, and the importance of urgent treatment with doxycycline if symptomatic. One Health professionals contribute ideas to manage ticks and rickettsial disease and provide broad education for the public and medical professionals. Novel management approaches include vaccine development and deployment, acaricide resistance monitoring, and modeling to guide targeted dog population management and other interventions.

Supplementary Materials

    • Supplementary Table S1 (PDF 120 KB)
    • Supplementary Table S2 (PDF 119 KB)
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