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ROCKY MOUNTAIN SPOTTED FEVER HOSPITALIZATIONS AMONG AMERICAN INDIANS

To describe the epidemiology of Rocky Mountain spotted fever (RMSF) among American Indians/Alaska Natives (AI/ANs), we conducted a retrospective analysis of hospitalization records with an RMSF diagnosis using Indian Health Service (IHS) hospital discharge data for calendar years 1980–2003. A total of 261 RMSF hospitalizations were reported among AIs, for an average annual hospitalization rate of 1.21 per 100,000 persons; two deaths were reported (0.8%). Most hospitalizations (88.5%) occurred in the Southern Plains region, where the rate was 4.23 per 100,000 persons. Children 1–4 years of age had the highest age-specific hospitalization rate of 2.50 per 100,000 persons. The overall annual RMSF hospitalization rate declined during the study period. Understanding the epidemiology of RMSF among AI/ANs and educating IHS/tribal physicians on the diagnosis of tick-borne diseases remain important for the prompt treatment of RMSF and the reduction of the disease occurrence among AI/ANs, particularly in high-risk areas.

Received November 30, 2005. Accepted for publication April 26, 2006.

Acknowledgments: The authors thank Jennifer McQuiston for helpful insights and Ryan DeLuche and Joanna Regan for technical assistance.

Disclosure: The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the funding agencies.

^* Address correspondence to Linda J. Demma, Division of Bacterial and Mycotic Diseases, MS D-63, Atlanta, GA 30333. E-mail: lqd1{at}cdc.gov

Authors’ addresses: Linda J. Demma, Division of Bacterial and Mycotic Diseases, MS D-63, Atlanta, GA 30333, Telephone: 404-639-3343, Fax: 404-639-3535, E-mail: lqd1{at}cdc.gov. Robert C. Holman, Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd., MS A-39, Atlanta, GA 30333, Telephone: 404-639-2433, Fax: 404-639-3838. Christina A. Mikosz, 1600 Clifton Rd., MS G-17, Atlanta, GA 30333. Aaron T. Curns, Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd., MS A-39, Atlanta, GA 30333, Telephone: 404-639-2136, Fax: 404-639-3838. David L. Swerdlow, Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd., MS G-13, Atlanta, GA 30333, Telephone: 404-639-1329, Fax: 404-639-4436, E-mail: dls3{at}cdc.gov. Edna L. Paisano, Division of Program Statistics, Office of Public Health Support, Indian Health Service, Rockville, MD 20852, Telephone: 404-639-2136, Fax: 404-639-3838, E-mail: Edna.Paisano{at}ihs.gov. James E. Cheek, Division of Epidemiology, Office of Public Health Support, Indian Health Service, Albuquerque, NM 87110, Telephone: 505-248-4226, Fax: 505-248-4393, E-mail: James.Cheek{at}ihs.gov.