Conceptual Framework for Community-Based Prevention of Brown Dog Tick-Associated Rocky Mountain Spotted Fever

Abstract

Rocky Mountain spotted fever (RMSF) is a severe tickborne disease that can reach epidemic proportions in communities with certain social and ecologic risk factors. In some areas, the case-fatality rate of brown dog tick-associated RMSF is up to 50%. Because of the spread of brown dog tick-associated RMSF in the southwestern United States and northern Mexico, the disease has the potential to emerge and become endemic in other communities that have large populations of free-roaming dogs, brown dog ticks, limited resources, and low provider awareness of the disease. By using a One Health approach, interdisciplinary teams can identify communities at risk and prevent severe or fatal RMSF in humans before cases occur. We have developed a conceptual framework for RMSF prevention to enable communities to identify their RMSF risk level and implement prevention and control strategies.

Keywords: Dermacentor species; Mexico; One Health; Rhipicephalus sanguineus; Rickettsia rickettsii; Rocky Mountain spotted fever; United States; bacteria; brown dog tick; health equity; tick-borne disease; ticks; vector-borne disease; zoonoses.

Figure 1

Community risk assessment for brown dog tick–associated RMSF. Communities with free-roaming dogs, high levels of brown dog ticks, and Rickettsia rickettsii in the dog or tick population are considered medium risk for RMSF transmission. Communities with those factors as well as inadequate community knowledge of tick prevention are considered high risk for RMSF transmission. If healthcare provider knowledge of RMSF diagnosis and treatment is also inadequate, the community is also considered high risk for severe illness or death from RMSF. RMSF, Rocky Mountain spotted fever.

Figure 2

Recommended goals and activities for community-based prevention of brown dog tick–associated RMSF on the basis of the risk assessment road map for medium- or high-risk communities (Figure 1). KAP, knowledge, attitudes, and practices; RMSF, Rocky Mountain spotted fever; SOP, standard operating procedure.