Description of Eschar-Associated Rickettsial Diseases Using Passive Surveillance Data — United States, 2010–2016

Abstract

What is already known about this topic? Eschars are a clinical sign used to differentiate less severe rickettsioses from potentially deadly Rocky Mountain spotted fever. What is added by this report? Eschars are infrequently reported in tickborne rickettsial disease (TBRD) surveillance data and represent an underutilized resource to aid in distinguishing the various spotted fever group Rickettsia. Although 1% of total TBRD case reports during 2010-2016 documented the presence of an eschar, 81% of cases lacked information on eschars altogether. What are the implications for public health practice? Systematic reporting of the presence or absence of eschars on the TBRD case report form can improve the quality of surveillance data and enhance understanding of the impact of spotted fever rickettsioses in the United States. © 2020 Department of Health and Human Services. All rights reserved.