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Rocky Mountain Spotted Fever in a Large Metropolitan Center, Mexico–United States Border, 2009–2019

  1. You are seeing a 14-year-old girl who reports a 4-day history of fever and fatigue. You are aware of multiple case reports of Rocky Mountain spotted fever (RMSF) in your community over the past several months. In the current study by Zazueta and colleagues, which of the following symptoms associated with RMSF was most common?
  2. What should you consider regarding the epidemiology of RMSF in the current study?
    Only 10% of cases were diagnosed in the city of Mexicali
    The 11-year incidence rate of RMSF was 230 cases/100,000 population
    The mean age of cases was 9 years
    Most cases occurred during summer months
  3. You order diagnostic testing for RMSF. What did the current study find regarding such testing?
    Most diagnostic assays in cases suspected for RMSF were positive
    Rates of positive indirect fluorescent antibody (IFA) testing were more than double that of positive polymerase chain reaction (PCR) testing
    Most patients who were hospitalized had a positive PCR test only
    IFA and PCR tests were nearly never both positive when ordered together
  4. What was the approximate mortality rate associated with RMSF in the current study?