• 1.

    Centers for Disease Control and Prevention, 2010. Summary of notifiable diseases–United States, 2008. MMWR Morb Mortal Wkly Rep 57: 29.

    • Search Google Scholar
    • Export Citation
  • 2.

    Adjemian JZ, Krebs J, Mandel E, McQuiston J, 2009. Spatial clustering by disease severity among reported Rocky Mountain spotted fever cases in the United States, 2001–2005. Am J Trop Med Hyg 80: 7277.

    • Search Google Scholar
    • Export Citation
  • 3.

    Sexton DJ, Walker DH, 2006. Spotted fever group rickettsioses. Guerrant RL, Walker DH, Weller PF, eds. Tropical Infectious Diseases: Principles, Pathogens, and Practice. Second edition. Philadelphia, PA: Elsevier Churchill Livingstone, 539547.

    • Search Google Scholar
    • Export Citation
  • 4.

    Helmick CG, Bernard KW, D'Angelo LJ, 1984. Rocky Mountain spotted fever: clinical, laboratory, and epidemiological features of 262 cases. J Infect Dis 150: 480488.

    • Search Google Scholar
    • Export Citation
  • 5.

    Dalton MJ, Clarke MJ, Holman RC, Krebs JW, Fishbein DB, Olson JG, Childs JE, 1995. National surveillance for Rocky Mountain spotted fever, 1981–1992: epidemiologic summary and evaluation of risk factors for fatal outcome. Am J Trop Med Hyg 52: 405413.

    • Search Google Scholar
    • Export Citation
  • 6.

    Buckingham SC, Marshall GS, Schutze GE, Woods CR, Jackson MA, Patterson LE, 2007. Clinical and laboratory features, hospital course, and outcome of Rocky Mountain spotted fever in children. J Pediatr 150: 180184.

    • Search Google Scholar
    • Export Citation
  • 7.

    Kirkland KB, Wilkinson WE, Sexton DJ, 1995. Therapeutic delay and mortality in cases of Rocky Mountain spotted fever. Clin Infect Dis 20: 11181121.

    • Search Google Scholar
    • Export Citation
  • 8.

    Purvis JJ, Edwards MS, 2000. Doxycycline use for rickettsial disease in pediatric patients. Pediatr Infect Dis J 19: 871874.

  • 9.

    Holman RC, Paddock CD, Curns AT, Krebs JW, McQuiston JH, Childs JE, 2001. Analysis of risk factors for fatal Rocky Mountain spotted fever: evidence for superiority of tetracyclines for therapy. J Infect Dis 184: 14371444.

    • Search Google Scholar
    • Export Citation
  • 10.

    American Academy of Pediatrics, 2012. Ehrlichia and Anaplasma infections, Rocky Mountain spotted fever. Pickering LK, Baker CJ, Kimberlin DW, Long SS, eds. Red Book: 2012 Report of the Committee on Infectious Diseases. 29th edition. Elk Grove Village, IL: American Academy of Pediatrics: 312315, 623625.

    • Search Google Scholar
    • Export Citation
  • 11.

    O'Reilly M, Paddock C, Elchos B, Goddard J, Childs J, Currie M, 2003. Physician knowledge of the diagnosis and management of Rocky Mountain spotted fever: Mississippi, 2002. Ann N Y Acad Sci 990: 295301.

    • Search Google Scholar
    • Export Citation
  • 12.

    Lochary ME, Lockhart PB, Williams WT Jr, 1998. Doxycycline and staining of permanent teeth. Pediatr Infect Dis J 17: 429431.

  • 13.

    Openshaw JJ, Swerdlow DL, Krebs JW, Holman RC, Mandel E, Harvey A, Haberling D, Massung RF, McQuiston JH, 2010. Rocky Mountain spotted fever in the United States, 2000–2007: interpreting contemporary increases in incidence. Am J Trop Med Hyg 83: 174182.

    • Search Google Scholar
    • Export Citation
  • 14.

    Kirkland KB, Wilkinson WE, Sexton DJ, 1995. Therapeutic delay and mortality in cases of Rocky Mountain spotted fever. Clin Infect Dis 20: 11181121.

    • Search Google Scholar
    • Export Citation
  • 15.

    Centers for Disease Control and Prevention, 2000. Consequences of delayed diagnosis of Rocky Mountain spotted fever in children: West Virginia, Michigan, Tennessee, and Oklahoma, May–July 2000. MMWR Morb Mortal Wkly Rep 49: 885888.

    • Search Google Scholar
    • Export Citation
 
 
 

 

 
 
 

 

 

 

 

 

 

Knowledge, Attitudes, and Practices Regarding Rocky Mountain Spotted Fever among Healthcare Providers, Tennessee, 2009

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  • Department of Health, Communicable and Environmental Diseases and Emergency Preparedness, Tennessee Department of Health, Nashville, Tennessee; Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention Atlanta, Georgia; West Tennessee Regional Office, Tennessee Department of Health, Jackson, Tennessee; Vanderbilt University School of Medicine, Nashville, Tennessee

Tennessee has a high incidence of Rocky Mountain spotted fever (RMSF), the most severe tick-borne rickettsial illness in the United States. Some regions in Tennessee have reported increased illness severity and death. Healthcare providers in all regions of Tennessee were surveyed to assess knowledge, attitudes, and perceptions regarding RMSF. Providers were sent a questionnaire regarding knowledge of treatment, diagnosis, and public health reporting awareness. Responses were compared by region of practice within the state, specialty, and degree. A high proportion of respondents were unaware that doxycycline is the treatment of choice in children ≤ 8 years of age. Physicians practicing in emergency medicine, internal medicine, and family medicine; and nurse practitioners, physician assistants, and providers practicing for < 20 years demonstrated less knowledge regarding RMSF. The gaps in knowledge identified between specialties, designations, and years of experience can help target education regarding RMSF.

Author Notes

* Address correspondence to Caleb Wiedeman, Communicable and Environmental Diseases Services, Tennessee Department of Health, 425 5th Avenue North, Nashville, TN 37243. E-mail: caleb.wiedeman@tn.gov

Financial support: This study was supported by a Prevention Emerging Infections Program grant from the Centers for Disease Control and the Tennessee Department of Health.

Authors' addresses: Emily Mosites, School of Public Health, University of Washington, Seattle, WA, E-mail: emosites@uw.edu. L. Rand Carpenter, Caleb Wiedeman, and John R. Dunn, Communicable and Environmental Diseases and Emergency Preparedness Sections, Tennessee Department of Health, Nashville, TN, E-mails: l.rand.carpenter@tn.gov, caleb.wiedeman@tn.gov, and john.dunn@tn.gov. Kristina McElroy, United States Army Veterinary Corps, Montgomery, AL, E-mail: k.mcelroy.dvm@gmail.com. Jennifer McQuiston, Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, GA, E-mail: fzh7@cdc.gov. Mary J. Lancaster, Pacific Northwest National Laboratory, Applied Statistics and Computational Modeling, Richland, WA, E-mail: Mary.Lancaster@pnnl.gov. Tue H. Ngo, Division of Infectious Diseases, Medical University of South Carolina, Charleston, SC, E-mail: ngoth@musc.edu.

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