{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T06:21:47Z","timestamp":1769062907285,"version":"3.49.0"},"reference-count":45,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012,1,1]]},"abstract":"<jats:p>American Indians are at greater risk for Rocky Mountain spotted fever (RMSF) than the general U.S. population. The epidemiology of RMSF among American Indians was examined by using Indian Health Service inpatient and outpatient records with an RMSF <jats:italic>International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis<\/jats:italic>. For 2001\u20132008, 958 American Indian patients with clinical diagnoses of RMSF were reported. The average annual RMSF incidence was 94.6 per 1,000,000 persons, with a significant increasing incidence trend from 24.2 in 2001 to 139.4 in 2008 (<jats:italic>P<\/jats:italic> = 0.006). Most (89%) RMSF hospital visits occurred in the Southern Plains and Southwest regions, where the average annual incidence rates were 277.2 and 49.4, respectively. Only the Southwest region had a significant increasing incidence trend (<jats:italic>P<\/jats:italic> = 0.005), likely linked to the emergence of brown dog ticks as an RMSF vector in eastern Arizona. It is important to continue monitoring RMSF infection to inform public health interventions that target RMSF reduction in high-risk populations.<\/jats:p>","DOI":"10.4269\/ajtmh.2012.11-0269","type":"journal-article","created":{"date-parts":[[2012,1,9]],"date-time":"2012-01-09T22:56:40Z","timestamp":1326149800000},"page":"152-158","source":"Crossref","is-referenced-by-count":21,"title":["Trends in Clinical Diagnoses of Rocky Mountain Spotted Fever among American Indians, 2001\u20132008"],"prefix":"10.4269","volume":"86","author":[{"given":"Arianne M.","family":"Folkema","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert C.","family":"Holman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer H.","family":"McQuiston","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James E.","family":"Cheek","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"R1","series-title":"J Infect Dis","first-page":"480","article-title":"Rocky Mountain spotted fever: clinical, laboratory, and epidemiological features of 262 cases","volume":"150","author":"Helmick","year":"1984"},{"key":"R2","series-title":"Lancet Infect Dis","first-page":"724","article-title":"Rocky Mountain spotted fever","volume":"7","author":"Dantas-Torres","year":"2007"},{"key":"R3","series-title":"Public Health Rep","first-page":"1465","article-title":"Rocky Mountain spotted fever","volume":"27","author":"Rucker","year":"1912"},{"key":"R4","series-title":"Arch Intern Med","first-page":"223","article-title":"Lower respiratory tract involvement in Rocky Mountain spotted fever","volume":"140","author":"Donohue","year":"1980"},{"key":"R5","series-title":"Arch Intern Med","first-page":"443","article-title":"Acute renal failure in Rocky Mountain spotted fever","volume":"139","author":"Walker","year":"1979"},{"key":"R6","series-title":"Neurol Clin","first-page":"801","article-title":"Central nervous system involvement in Rickettsial diseases","volume":"17","author":"Bleck","year":"1999"},{"key":"R7","series-title":"Am J Trop Med Hyg","first-page":"174","article-title":"Rocky Mountain spotted fever in the United States, 2000\u20132007: interpreting contemporary increases in incidence","volume":"83","author":"Openshaw","year":"2010"},{"key":"R8","series-title":"Public Health Rep","first-page":"469","article-title":"Incidence of Rocky Mountain spotted fever among American Indians in Oklahoma","volume":"115","author":"McQuiston","year":"2000"},{"key":"R9","series-title":"Am J Trop Med Hyg","first-page":"601","article-title":"Increasing incidence of Rocky Mountain spotted fever among the American Indian population in the United States","volume":"80","author":"Holman","year":"2009"},{"key":"R10","series-title":"Am J Trop Med Hyg","first-page":"537","article-title":"Rocky Mountain spotted fever hospitalizations among American Indians","volume":"75","author":"Demma","year":"2006"},{"key":"R11","series-title":"Am J Trop Med Hyg","first-page":"405","article-title":"National surveillance for Rocky Mountain spotted fever, 1981\u20131992: epidemiologic summary and evaluation of risk factors for fatal outcome","volume":"52","author":"Dalton","year":"1995"},{"key":"R12","series-title":"MMWR Recomm Rep","first-page":"1","article-title":"Diagnosis and management of tickborne rickettsial diseases: Rocky Mountain spotted fever, ehrlichioses, and anaplasmosis\u2013United States: a practical guide for physicians and other health-care and public health professionals","volume":"55","author":"Chapman","year":"2006"},{"key":"R13","series-title":"Am J Trop Med Hyg","first-page":"21","article-title":"Rocky Mountain spotted fever in the United States, 1993\u20131996","volume":"63","author":"Treadwell","year":"2000"},{"key":"R14","series-title":"N Engl J Med","first-page":"587","article-title":"Rocky Mountain spotted fever from an unexpected tick vector in Arizona","volume":"353","author":"Demma","year":"2005"},{"key":"R15","series-title":"HCUP NIS Database Documentation","author":"Healthcare Cost and Utlization Project (HCUP)","year":"2011"},{"key":"R16","series-title":"National Hospital Discharge Survey","author":"National Center for Health Statistics","year":"2011"},{"key":"R17","series-title":"J Rural Health","first-page":"269","article-title":"Access to specialty health care for rural American Indians in two states","volume":"24","author":"Baldwin","year":"2008"},{"key":"R18","series-title":"Soc Sci Med","first-page":"393","article-title":"Access to ambulatory care for American Indians and Alaska Natives; 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