Abstract

Simple SummaryRocky Mountain spotted fever (RMSF) is among the most fatal of all bacterial diseases in the Americas. Humans become ill through the bite of ticks infected with the bacterium Rickettsia rickettsii. Several biological, environmental, and social determinants play a role in the occurrence of the disease, which has extended its presence throughout the region. To prevent this medical threat, innovative interventions has been implemented in some communities, although they still do not have a widespread application and have not been used in combination. In this study, we examined through mathematical models the potential benefit of combining insecticidal dog collars and long-lasting wall treatments to reduce the burden of ticks in a socially vulnerable Mexican community with a high burden of cases and deaths due to RMSF. Overall, we found that if enough coverage is given for either treatment, the other one can be omitted. Both interventions have the potential to lessen the burden of ticks and may help to lower the risk to be ill from RMSF in communities such as of our study. We recommend further research including some other factors (i.e., political, budgetary, socioeconomics) linked to the disease.Rocky Mountain spotted fever (RMSF) is a significant health problem in Sonora, Mexico. The tick vector, Rhipicephalus sanguineus, feeds almost exclusively on domestic dogs that, in this region, also serve as the reservoir for the tick-borne pathogen, Rickettsia rickettsii. A process-based mathematical model of the life cycle of R. sanguineus was developed to predict combinations of insecticidal dog collars and long-lasting insecticidal wall treatments resulting in suppression of indoor tick populations. Because of a high burden of RMSF in a rural community near the Sonora state capital of Hermosillo, a test area was treated with a combination of insecticidal dog collars and long-lasting insecticidal wall treatments from March 2018 to April 2019, with subsequent reduction in RMSF cases and deaths. An estimated 80% of the dogs in the area had collars applied and 15% of the houses were treated. Data on tick abundance on walls and dogs, collected during this intervention, were used to parameterize the model. Model results show a variety of treatment combinations likely to be as successful as the one carried out in the test community.

Highlights

  • Rocky Mountain spotted fever (RMSF) is a deadly disease

  • This study focuses on tick populations observed on both walls and dogs of Community A, in which dog collars were combined with three types of acaricidal wall treatments, and with visual inspections of houses and dogs used to track changes in tick abundance

  • Rocky Mountain spotted fever is a medical threat and public health concern that needs to be addressed by means of innovative and comprehensive strategies, such as those carried out and modeled in this study

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Summary

Introduction

Rocky Mountain spotted fever (RMSF) is a deadly disease. The reported fatality rate can be as high as 30–80% in some areas if specific treatment is not initiated in time [1–4]. Symptoms of the disease include fever, headache, rash, and malaise. Clinical complications can produce a myriad of adverse outcomes such as hemorrhage, purpura, necrosis, hepatic failure, acute kidney injury, meningismus, and cardiopulmonary involvement, among others [5–10]. Ill patients may suffer organ failure and those who recover may develop long-term consequences [1,11,12]. Isolated cases and familial clusters can appear throughout the Americas [1], localized Rocky Mountain spotted fever outbreaks can occur, as in some communities in northern Mexico [5,13–15]. Cases have been reported in the region since 1940 [1]. A high incidence of cases is reported in Arizona tribal lands [16]. The disease is caused by the bacteria Rickettsia rickettsii, transmitted in Mexico, through the bite of its main tick vector, Rhipicephalus sanguineus [17]

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