Features of Selected Rickettsial Infections
| Disease | Organism | Transmission | Geographic Range | Incubation Period, Days | Duration, Days | Rash, % | Eschar, % | Lymphadenopathya |
|---|---|---|---|---|---|---|---|---|
| Rocky Mountain spotted fever | Rickettsia rickettsii | Tick bite: Dermacentor andersoni, D. variabilis | United States | 2-14 | 10-20 | 90 | <1 | + |
| Amblyomma cajennense, A. aureolatum | Central/South America | |||||||
| Rhipicephalus sanguineus | Mexico, Brazil, United States | |||||||
| Mediterranean spotted fever | R. conorii | Tick bite: R. sanguineus, Rhipicephalus pumilio | Southern Europe, Africa, Middle East, Central Asia | 5-7 | 7-14 | 97 | 50 | + |
| African tick-bite fever | R. africae | Tick bite: A. hebraeum, A. variegatum | Sub-Saharan Africa, West Indies | 4-10 | 4-19 | 50 | 90 | ++++ |
| Maculatum disease | R. parkeri | Tick bite: A. maculatum | United States, South America | 2-10 | 6-16 | 88 | 94 | ++ |
| Rickettsialpox | R. akari | Mite bite: Liponyssoides sanguineus | United States, Ukraine, Turkey, Mexico, Croatia | 10-17 | 3-11 | 100 | 90 | +++ |
| Tick-borne lymphadenopathy | R. slovaca | Tick bite: D. marginatus, D. reticularis | Europe | 7-9 | 17-180 | 5 | 100 | ++++ |
| Flea-borne spotted fever | R. felis | Flea (mechanism undetermined): Ctenocephalides felis | Worldwide | 8-16 | 8-16 | 80 | 15 | — |
| Epidemic typhus | R. prowazekii | Louse feces: Pediculus humanus corporis, fleas and lice of flying squirrels, or recrudescence | Worldwide | 7-14 | 10-18 | 80 | None | — |
| Murine typhus | R. typhi | Flea feces: Xenopsylla cheopis, C. felis, others | Worldwide | 8-16 | 9-18 | 80 | None | — |
| Human monocytotropic ehrlichiosis | Ehrlichia chaffeensis | Tick bite: A. americanum, D. variabilis | United States | 1-21 | 3-21 | 26 | None | ++ |
| Ewingii ehrlichiosis | E. ewingii | Tick bite: A. americanum | United States | 1-21 | 4-21 | 0 | None | |
| Unnamed ehrlichiosis | E. muris-like agent | Tick bite: Ixodes scapularis | United States | Unknown | 3-14 | None | None | |
| Human granulocytotropic anaplasmosis | Anaplasma phagocytophilum | Tick bite: I. scapularis, I. ricinus, I. pacificus, I. persulcatus | United States, Europe, Asia | 4-8 | 3-14 | Rare | None | — |
| Unnamed disease | Candidatus Neoehrlichia mikurensis | Tick bite: I. ricinus, I. persulcatus, Haemaphysalis concinna | Europe, China | ≥8 | 11-75 | 10 | None | |
| Scrub typhus | Orientia tsutsugamushi | Mite bite: Leptotrombidium deliense, others | Asia, Australia, Pacific and Indian Ocean islands | 9-18 | 6-21 | 50 | 35 | +++ |
| Q fever | Coxiella burnetii | Inhalation of aerosols of infected parturition material (goats, sheep, cattle, cats, others), ingestion of infected milk or milk products | Worldwide except New Zealand, Antarctica | 3-30 | 5-57 | <1 | None | — |
a++++, severe; +++, marked; ++, moderate; +, present in a small proportion of cases; —, not a noted feature.