In recent years, rickettsialpox was infrequently reported: one case per year was recorded by the Public Health Service during the past 15 years. We observed a case of rickettsialpox in New York City and reviewed the clinical, diagnostic, and epidemiologic features. Records of the New York City Health Department showed that serum samples from only six patients were submitted for serological testing for rickettsialpox during the past ten years, suggesting that although the disease is uncommon now, clinicians may be failing to recognize and diagnose rickettsialpox, as it may occur more frequently than is presently recognized.
(JAMA 242:1998-1999, 1979)
Wong B, Singer C, Armstrong D, Millian SJ. RickettsialpoxCase Report and Epidemiologic Review. JAMA. 1979;242(18):1998–1999. doi:10.1001/jama.1979.03300180042031