Rickettsiosis subcommittee report to the tick-borne disease working group

David H. Walker, CDR Todd E. Myers, Lucas S. Blanton, Karen C. Bloch, Vance G. Fowler, David N. Gaines, Christopher D. Paddock, Hayley D. Yaglom

Research output: Contribution to journalArticlepeer-review


Tick-borne rickettsial infections are serious, common, and difficult to diagnose. Among the most important factors leading to failure to diagnose and treat tick-borne rickettsioses effectively is a lack of consideration of the potential diagnosis by primary caregivers and emergency department physicians in patients presenting with undifferentiated acute febrile illness during tick season. This situation exists because of insufficient primary and continuing medical education of medical students, primary care and emergency medicine residents, and practicing physicians regarding tick-borne rickettsioses specific to the region where they practice. Delayed initiation of treatment with an appropriate antibiotic is associated with adverse outcomes including increased rates of hospitalization, admission to an intensive care unit, and mortality. The earliest symptoms are nonspecific, consisting of fever, headache, myalgias, and nausea and/or vomiting. Laboratory abnormalities are typically absent at this time when the therapeutic response to an appropriate antibiotic would be optimal. There is a mistaken idea among a substantial portion of physicians that the best antibiotic available, doxycycline, should not be administered to children 8 years of age or younger or during pregnancy. For all of the above reasons, there is unnecessary morbidity and mortality caused by tick-borne rickettsioses. This report proposes measures to address these critical issues regarding tick-borne rickettsioses.

Original languageEnglish (US)
Article number101855
JournalTicks and Tick-borne Diseases
Issue number1
StatePublished - Jan 2022


  • Clinical awareness and knowledge
  • Epidemiologic surveillance
  • Laboratory diagnosis
  • Rickettsia
  • Ticks

ASJC Scopus subject areas

  • Parasitology
  • Microbiology
  • Insect Science
  • Infectious Diseases


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