Epidemiology of Rocky Mountain spotted fever as determined by active surveillance

Prospective, active surveillance for Rocky Mountain Spotted fever (RMSF) was undertaken in two North Carolina counties for the years 1979-1981. Appropriate age, sex, and geographically matched controls were compared with the serologically confirmed cases of disease. Patients who were suspected of having infection, but were shown not to have RMSF, were also compared with the serologically proven cases. Ninety-eight cases were identified, and three of these patients died. The mean annual incidence of RMSF in these two counties was 14.59 cases/100,000 population. Identified cases occurred between the months of March and September. The overall mean annual incidence for men was 19.65/100,000 and for women 10.3/100,000. The study suggests that persons contracting RMSF are exposed to the vectors at their residences, which tend to be detached dwellings in woody, brushy areas. Children are more likely than adults both to be seen by physicians early in the illness and to be checked for ticks. Eighty-four percent of patients with serologically confirmed cases developed a rash. The epidemiology of RMSF in these two endemic counties is described.