An Increase in Human Cases of Spotted Fever Rickettsiosis in Yucatan, Mexico, Involving Children

Abstract

The first human case of infection caused by Rickettsia in Yucatan was detected in 1996, and it was determined that the species was R. felis. Since then, passive epidemiologic surveillance was implemented to search for human cases in the public hospitals of the state, and in 2005, the first human case of Rocky Mountain spotted fever was detected. During the following 2 years, eight new confirmed cases and one probable case were identified. Seven cases involved children younger than 12 years of age, with a fatal outcome in three of the cases. Children are a particularly vulnerable population for this serious emerging infection.

Clinical Profile and Predictors of Fatal Rocky Mountain Spotted Fever in Children from Sonora, Mexico

“…The overall CFR (20%) in children from Sonora is much higher than that reported in the United States, which ranges from 0.5% to 11.7% 10,14-16 although it is below than the rate observed (42%) in a small pediatric series from the south of Mexico, 6 and similar to that documented in pediatric population living in endemic regions from Brazil. The overall CFR (20%) in children from Sonora is much higher than that reported in the United States, which ranges from 0.5% to 11.7% 10,14-16 although it is below than the rate observed (42%) in a small pediatric series from the south of Mexico, 6 and similar to that documented in pediatric population living in endemic regions from Brazil.…”

“…6,11,18,19 Fever, headache and exanthema constituted the predominant symptoms of RMSF, which might not be helpful to distinguish it from other endemic diseases in Mexico such as dengue fever, viral hepatitis or leptospirosis. 6,11,18,19 Fever, headache and exanthema constituted the predominant symptoms of RMSF, which might not be helpful to distinguish it from other endemic diseases in Mexico such as dengue fever, viral hepatitis or leptospirosis.…”

Update on Tick-Borne Rickettsioses around the World: a Geographic Approach

“…Despite the current availability of an effective treatment and advances in medical care, an estimated 5% to 10% of U.S. patients die when infected with R. rickettsii (48,61,87). For unknown reasons, case-fatality rates in Central America are considerably higher: estimates from recent outbreaks in Mexico are as high as 38% (88)(89)(90)(91), and the case-fatality rate of 6 documented RMSF cases in Panama during 2004 to 2007 was 100% (50,92).…”

Fiebre maculosa de las Montañas Rocosas en niños y adolescentes mexicanos: cuadro clínico y factores de mortalidad

“…4 Por razones desconocidas, hubo un registro aislado de casos hasta comienzos de la década pasada cuando se documentó su presencia en Sonora y otros estados del país. [5][6][7] La FMMR es una enfermedad reemergente en Sonora, al noroeste de México, así como en otras regiones del país, 8 con una creciente incidencia y elevada letalidad. En México se transmite por la mordedura de la garrapata Rhipicephalus sanguineus, parásito común en los perros.…”