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Volume 23, Number 10—October 2017


Fatal Rocky Mountain Spotted Fever along the United States–Mexico Border, 2013–2016

Naomi A. DrexlerComments to Author , Hayley Yaglom, Mariana Casal, Maria Fierro, Paula Kriner, Brian Murphy, Anne Kjemtrup, and Christopher D. Paddock
Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (N.A. Drexler, C.D. Paddock); Arizona Department of Health Services, Phoenix, Arizona, USA (H. Yaglom, M. Casal); Imperial County Public Health Department, El Centro, California, USA (M. Fierro, P. Kriner); County of San Diego Health and Human Services Agency, San Diego, California, USA (B. Murphy); California Department of Public Health, Sacramento, California, USA (A. Kjemtrup)

Main Article


Selected epidemiologic and clinical elements from patients with fatal cases of RMSF along the US–Mexico border, 2013–2016*

Element Case-patient 1 Case-patient 2 Case-patient 3 Case-patient 4
Patient history
Known exposure in RMSF-epidemic area of Mexico + + +
Evidence of receipt of medical care in Mexico + +
Prescribed nontetracycline antimicrobial drug
Signs and symptoms at initial presentation
Fever + + + +
Headache + +
Nausea/vomiting/diarrhea + +

Severe end-stage manifestations
Skin necrosis + + +
Rash + + + +
Respiratory failure + + + +
Disseminated intravascular coagulation +

*RMSF, Rocky Mountain spotted fever; +, present; blank cells, absent.

Main Article