Distribution and Incidence

Known only in the Western Hemisphere, Rocky Mountain spotted fever has been identified in Canada, the United States, Mexico, Costa Rica, Panama, Brazil, and Colombia. Before 1940, most cases were reported in the Rocky Mountain region, but since that time, the number of cases in the southeastern and southwestern United States (sometimes called the "tick belt" region) has far outstripped those reported from the west. In the 1970s, case incidence in the United States began to rise, reaching a peak of 1,192 cases in 1981. In recent years, the number of cases has declined slightly and leveled off. At present, Oklahoma has the highest infection rate in relation to its population, whereas North Carolina reports the largest number of cases. A small number of cases continues to occur in Canada. In Mexico and Central and South America, the disease is poorly reported, and consequently it is difficult to estimate its actual incidence in these areas.

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