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RMSF (Rocky Mountain Spotted Fever)

RMSF (Rocky Mountain Spotted Fever). 3 rd Arizona Statewide Tribal, IHS, ADHS, CDC Rocky Mountain Spotted Fever Meeting December 3, 2013. RMSF: Background. Caused by Rickettsia rickettsii Tickborne , no person-to-person transmission

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RMSF (Rocky Mountain Spotted Fever)

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  1. RMSF(Rocky Mountain Spotted Fever) 3rd Arizona Statewide Tribal, IHS, ADHS, CDC Rocky Mountain Spotted Fever Meeting December 3, 2013

  2. RMSF: Background • Caused by Rickettsia rickettsii • Tickborne , no person-to-person transmission • Found in several species of ticks throughout North and South America • Intracellular bacterial pathogen • Infects endothelial cells, causes widespread vascular damage • Effectively treated with doxycycline • Other antibiotics (even broad spectrum) ineffective • Marc Traeger, MD, Whiteriver Service Unit, IHS

  3. Number of Cases of RMSF

  4. 10 years of workWRSUJune 2002 – April 201212 pages = 219 items

  5. Onset of RMSF symptoms by age in two Arizona communities n=205 CDC unpublished data from chart review of RMSF cases in two communities in Arizona, 2002-2011

  6. Selected reportable disease case counts Arizona, 2011 Data from MMWR: Summary of Notifiable Diseases, United States, 2011

  7. Years of Potential Life Lost (YPLL) Trends in Indian Health (2002-3)

  8. Better than Average Worse than Average Risk Profile of American Indians 2009 (Percent above or below the average rate or ratio of all Arizona residents in 2009) http://www.azdhs.gov/plan/report/hspam/indian09.pdf 0 +250% -250%

  9. http://www.azdhs.gov/plan/report/hspam/indian09.pdf

  10. Ticks

  11. International Comparison of Spending on Health Source: Commonwealth Fund, based on OECD Health Data 2012.

  12. International Comparison of Spending on Health

  13. Clinical Education and Enhanced Surveillance

  14. RMSF Rodeo Partners

  15. The diagnosis and treatment algorithm for AZ Patient Presents with Fever (T > 100) or History of Subjective Fever Fever > 2 days? (48 hours) Yes No Educate Patient & Follow-up Next Day Any 1 of the following: Rash? Low Sodium? Low Platelets? Elevated AST or ALT? Recent Exposure to Ticks or Untreated Dogs? Doxycycline & RMSF Labs Yes No or Unknown

  16. Where we are… • Awareness and education • Science • Will • Prevention • Treatment • Infrastructure • Temporary funding

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