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APHA Scientific Session and Event Listing

Mushfiqur R. Tarafder, College of Public Health, University of Oklahoma, 801 NE 13th Street, CHB#317, Oklahoma City, OK 73104, 405-271-2229 ext.48081, jrinsky@asph.org

Background: Rocky Mountain Spotted Fever (RMSF), endemic in Oklahoma, is the most severe and frequently reported tick-borne rickettsial illness in United States.

Objective: To describe the epidemiology of all seropositive RMSF cases reported to Oklahoma State Department of Health (OSDH) from January 2003 to May 2004 and compare CDC reportable cases to non-reportable cases.

Methods: All electronic and laboratory reports sent to OSDH were investigated. Demographics, symptoms, serology, treatment and tick exposure information was collected from patients, hospitals and physicians. Cases were classified as confirmed, probable, or not a case based on CDC definition. The association between age, sex, race, hospitalization, region of residence, exposure to tick-infested area, tick bite association and case status (reportable or not) was estimated using a multivariate logistic regression.

Results: Data from 291 seropositive persons were reviewed. Of these, 168 were reportable (57.7%). In 1-14 year-old group, the adjusted odds ratio (aOR) among those hospitalized was 8.74 (95% CI: 1.38;55.51). aOR for those who were hospitalized in 15-29, 30-44, 45-59, and „d60-year-old group were 0.65 (0.14;2.98), 3.73 (1.07;12.97), 3.97 (1.15;13.79), and 2.41 (0.72;8.11), respectively. The OR for those who were exposed to tick infested areas was 4.9 (1.61;14.98).

Discussion: Age modifies the effect of hospitalization on being a reportable case with a higher probability of being reportable among the 1-14 years-old. This may be due to more severe symptoms at this age when immunity is lower. Exposure to tick-infested area is a surrogate for actual tick bite and was found strongly associated with case status.

Learning Objectives:

• RMSF is endemic in Oklahoma and a major public health problem. The people of the state may benefit from educational campaigns emphasizing on personal protection from tick bites and exposure to tick habitats. Special attention should be given to the under 15 age group if there’s any suspicion of RMSF. Prompt and adequate medical care must be ensured, particularly for this group. Only through increased awareness of the epidemiology of the disease can Rocky Mountain Spotted Fever be controlled in the State of Oklahoma.

Keywords: Communicable Disease,

Presenting author's disclosure statement:

Not Answered