A Focus of Rocky Mountain Spotted Fever within New York City

Miklos P. Salgo, Edward E. Telzak, Brian Currie, David C. Perlman, Nathan Litman, Michael Levi, Gerald Nathenson, Jorge L. Benach, Rafi al-Hafidh, Joan Casey

Research output: Contribution to journalArticlepeer-review

70 Scopus citations


In the spring and summer of 1987, four persons acquired Rocky Mountain spotted fever within New York City, an area in which the disease had not previously been known to be endemic. Three of the four patients were residents of the Soundview area of the Bronx. All diagnoses were confirmed by indirect fluorescent antibody tests. Environmental investigation revealed that the tick vector for Rickettsia rickettsii, Dermacentor variabilis, was present in a local park. Of the 66 specimens of D. variabilis collected, 5 (8 percent) were positive for rickettsiae from the spotted fever group. Of an additional 96 specimens of D. variabilis, 5 (5 percent) were found positive for rickettsiae by a more specific monoclonal antibody assay. Eight additional New York City parks in all five boroughs were searched for ticks. D. variabilis was found in only one other park; of the 147 ticks collected there, none were positive for rickettsiae. These findings emphasize the focal nature of Rocky Mountain spotted fever and the need to consider that disease in the differential diagnosis of any obscure acute febrile illness, even in the absence of a history of travel to known endemic areas. (N Engl J Med 1988; 318:1345–8.)

Original languageEnglish (US)
Pages (from-to)1345-1348
Number of pages4
JournalNew England Journal of Medicine
Issue number21
StatePublished - May 26 1988

ASJC Scopus subject areas

  • General Medicine


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