{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T07:45:03Z","timestamp":1787125503142,"version":"build-2736575974"},"reference-count":43,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,1,6]]},"abstract":"\n Spotted fever group (SFG) rickettsioses are notifiable conditions in the United States caused by the highly pathogenic\n Rickettsia rickettsii<\/jats:italic>\n and less pathogenic rickettsial species such as\n Rickettsia parkeri<\/jats:italic>\n and\n Rickettsia<\/jats:italic>\n sp. 364D. Surveillance data from 2008 to 2012 for SFG rickettsioses are summarized. Incidence increased from 1.7 cases per million person-years (PY) in 2000 to 14.3 cases per million PY in 2012. During 2008\u20132012, cases of SFG rickettsiosis were more frequently reported among males, persons of white race, and non-Hispanic ethnicity. Overall, case fatality rate (CFR) was low (0.4%), however, risk of death was significantly higher for American Indian\/Alaska Natives (relative risk [RR] = 5.4) and Asian\/Pacific Islanders (RR = 5.7) compared with persons of white race. Children aged < 10 years continue to experience the highest CFR (1.6%). Higher incidence of SFG rickettsioses and decreased CFR likely result from increased reporting of tick-borne disease including those caused by less pathogenic species. Recently, fewer cases have been confirmed using species-specific laboratory methods (such as cell culture and DNA detection using polymerase chain reaction [PCR] assays), causing a clouded epidemiological picture. Use of PCR and improved documentation of clinical signs, such as eschars, will better differentiate risk factors, incidence, and clinical outcomes of specific rickettsioses in the future.\n <\/jats:p>","DOI":"10.4269\/ajtmh.15-0472","type":"journal-article","created":{"date-parts":[[2015,8,31]],"date-time":"2015-08-31T22:18:47Z","timestamp":1441059527000},"page":"26-34","source":"Crossref","is-referenced-by-count":102,"title":["National Surveillance of Spotted Fever Group Rickettsioses in the United States, 2008\u20132012"],"prefix":"10.4269","volume":"94","author":[{"given":"Naomi A.","family":"Drexler","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F. Scott","family":"Dahlgren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristen Nichols","family":"Heitman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert F.","family":"Massung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher D.","family":"Paddock","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Casey Barton","family":"Behravesh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"ref1","series-title":"Clin Microbiol Rev","first-page":"719","article-title":"Tick-borne rickettsioses around the world: emerging diseases challenging old concepts","volume":"18","author":"Parola","year":"2005"},{"key":"ref2","series-title":"Am J Trop Med 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