MSMR. 2020 Sep;27(9):17-23.
Spotted fever rickettsioses (SFR) are emerging in the Atlantic and Central regions of the U.S., though cases have been reported across the contiguous U.S. Military populations may be at increased risk for SFR because of residence in these regions and frequent field training in tick habitats. Surveillance for Rocky Mountain spotted fever in the Army began in 1998 and was expanded to include all SFR in 2017. Between 2016 and 2017, the rate of active component cases reported from Army installations in the Atlantic and Central regions of the U.S. increased nearly five-fold from 2016 (0.55 per 100,000 person-years [p-yrs]) to 2017 (2.65 per 100,000 p-yrs). The majority of SFR cases were reported from Fort Leonard Wood, MO, and Fort Bragg, NC. Most reported cases had no documented symptoms consistent with SFR and could not be confirmed as "cases" by standard case-defining methods. SFR surveillance and control efforts in military populations can be improved by better adherence to guidelines for SFR diagnosis and through the use of available advanced laboratory techniques.
斑点热立克次体病（SFR）正在美国大西洋和中部地区出现，尽管整个美国都有病例报告。由于居住在这些地区和频繁在蜱栖息地进行实地训练，军事人员可能面临更高的 SFR 风险。1998 年开始对陆军中的落基山斑点热进行监测，并于 2017 年扩大到包括所有 SFR。2016 年至 2017 年期间，美国大西洋和中部地区陆军驻地报告的现役病例率从 2016 年的每 100,000 人年 0.55 例增加了近五倍，达到 2017 年的每 100,000 人年 2.65 例。大多数 SFR 病例报告来自密苏里州的伦纳德伍德堡和北卡罗来纳州的布拉格堡。大多数报告的病例没有与 SFR 一致的明确症状，并且不能通过标准病例定义方法确认为“病例”。通过更好地遵守 SFR 诊断指南，并利用现有先进的实验室技术，可以改善军事人群中的 SFR 监测和控制工作。
