May 16, 2016
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CDC updates guidance on tick-borne rickettsial diseases

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The CDC published clinical and public health guidance on the diagnosis and management of several emerging tick-borne rickettsial diseases in a recent MMWR.

The report — developed by the CDC Rickettsial Zoonoses Branch and external academic, clinical and public health experts — updates the CDC’s 2006 recommendations and includes information concerning Rocky Mountain spotted fever (RMSF), ehrlichioses, anaplasmosis and other related illnesses. The guidance does not include rickettsial pathogens transmitted by nontick arthropods such as fleas, lice and mites.

“Tick-borne rickettsial diseases continue to cause severe illness and death in otherwise healthy adults and children, despite the availability of effective antibacterial therapy,” Holly M. Biggs, MD, MPH, an epidemic intelligence service officer in the CDC’s National Center for Emerging and Zoonotic Infectious Diseases, and colleagues wrote. “Early signs and symptoms of tick-borne rickettsial illnesses are nonspecific, and most cases of RMSF are misdiagnosed at the patient’s first visit for medical care, even in areas where awareness of RMSF is high.

“To increase the likelihood of an early, accurate diagnosis, health care providers should be familiar with risk factors, signs and symptoms consistent with tick-borne rickettsial diseases.”

The report also includes information on advising patients how best to avoid tick bites, as well as how to report probable and confirmed cases of these diseases to the appropriate public health authorities.

Reference:

Biggs HM, et al. MMWR Morb Mortal Wkly Rep. 2016;doi:10.15585/mmwr.rr6502a1.