Emory University School of Medicine
Emory University School of Medicine
Department of Pediatrics

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Department of Pediatrics

Rocky Mountain Spotted Fever (RMSF)

Rocky Mountain Spotted Fever (RMSF)

- Rickettsia rickettsi

Rocky Mountain spotted fever (RMSF), caused by Rickettsia rickettsii, is a severe tick-borne bacterial disease. Northern Mexico is a historically endemic region that has recently experienced an unprecedented reemergence of RMSF with an exceptionally high case fatality rate (CFR) ranging from 15-50%, higher than what was common in the pre-antibiotic era in the U.S. We have partnered with collaborators in Sonora, Mexico to begin to examine drivers of fatality in this region evaluating human cases, vector populations, pathogen factors and more. The goal of this work is to identify intervention points, prevention methods and treatment strategies to alleviate the high morbidity and mortality caused by RMSF in this region.  

Selected publications: 

  • Bellman S, McCoy KD, Enriquez D, Romo P, Hwang J, Weimer K, Gunter SM, Alomía-Zegarra MD, Murray KO, Álvarez-Hernández G. Predictors of Fatal Outcomes in Pediatric Rocky Mountain Spotted Fever from Two Decades of Hospitalized Cases in Sonora, Mexico, 2004-2024. Emerg Infect Dis. https://doi.org/10.3201/eid3202.251223.

Other Selected Publications related to Rickettsiosis 

  • Murray KO, Evert N, Mayes B, Fonken E, Erickson T, Garcia MN, Sidwa T. Typhus Group Rickettsiosis, Texas, USA, 2003-2013. Emerg Infect Dis. 2017 Apr;23(4):645-648. doi: 10.3201/eid2304.160958. PMID: 28322701; PMCID: PMC5367421. 
  • Erickson T, da Silva J, Nolan MS, Marquez L, Munoz FM, Murray KO. Newly Recognized Pediatric Cases of Typhus Group Rickettsiosis, Houston, Texas, USA. Emerg Infect Dis. 2017 Dec;23(12):2068-2071. doi: 10.3201/eid2312.170631. PMID: 29148369; PMCID: PMC5708246. 
  • Erickson TA, Ronca SE, Gunter SM, Brown EL, Hasbun R, Murray KO. Zoonotic Disease Testing Practices in Pediatric Patients with Meningitis and Encephalitis in a Subtropical Region. Pathogens. 2022 Apr 22;11(5):501. doi: 10.3390/pathogens11050501. PMID: 35631022; PMCID: PMC9145480. 
  • Nelson A, Downey M, Murry M, Weber B, Aguirre E, McCrea RS 3rd, Mims J, Vigilant M, Standlee C, Murray KO, Kneubehl A, Brown EL, Essigmann HT, Gunter SM. Emerging Tick-Borne Disease Risk in an Urban Center of Harris County, Texas. Vector Borne Zoonotic Dis. 2025 Dec;25(12):734-741. doi: 10.1177/15303667251386209. Epub 2025 Oct 20. PMID: 41115719. 
  • Reeves WK, Murray KO, Meyer TE, Bull LM, Pascua RF, Holmes KC, Loftis AD. Serological evidence of typhus group rickettsia in a homeless population in Houston, Texas. J Vector Ecol. 2008 Jun;33(1):205-7. doi: 10.3376/1081-1710(2008)33[205:seotgr]2.0.co;2. PMID: 18697325. 
  • Erickson T, Gunter SM, Starke J, Murray KO. Evidence of locally acquired spotted fever group rickettsioses in Southeast Texas, 2008-2016. Zoonoses Public Health. 2018 Nov;65(7):897-901. doi: 10.1111/zph.12518. Epub 2018 Aug 27. PMID: 30152119.