{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T06:04:19Z","timestamp":1790316259184,"version":"4.1.0"},"reference-count":51,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2010,7]]},"abstract":"<jats:p>Rocky Mountain spotted fever (RMSF), a potentially fatal tick-borne infection caused by <jats:italic>Rickettsia rickettsii<\/jats:italic>, is considered a notifiable condition in the United States. During 2000 to 2007, the annual reported incidence of RMSF increased from 1.7 to 7 cases per million persons from 2000 to 2007, the highest rate ever recorded. American Indians had a significantly higher incidence than other race groups. Children 5\u20139 years of age appeared at highest risk for fatal outcome. Enzyme-linked immunosorbent assays became more widely available beginning in 2004 and were used to diagnose 38% of cases during 2005\u20132007. The proportion of cases classified as confirmed RMSF decreased from 15% in 2000 to 4% in 2007. Concomitantly, case fatality decreased from 2.2% to 0.3%. The decreasing proportion of confirmed cases and cases with fatal outcome suggests that changes in diagnostic and surveillance practices may be influencing the observed increase in reported incidence rates.<\/jats:p>","DOI":"10.4269\/ajtmh.2010.09-0752","type":"journal-article","created":{"date-parts":[[2010,7,1]],"date-time":"2010-07-01T16:25:01Z","timestamp":1278001501000},"page":"174-182","source":"Crossref","is-referenced-by-count":127,"title":["Rocky Mountain Spotted Fever in the United States, 2000\u20132007: Interpreting Contemporary Increases in Incidence"],"prefix":"10.4269","volume":"83","author":[{"given":"John J.","family":"Openshaw","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David L.","family":"Swerdlow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John 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