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November 22, 1995

Rocky Mountain Spotted Fever: Legal Duty to Warn for Noncontagious Disease

Author Affiliations

Memphis, Tenn

JAMA. 1995;274(20):1586-1587. doi:10.1001/jama.1995.03530200022024

To the Editor.  —Physicians have both a medical and a legal duty to warn the family members of patients with contagious diseases, such as meningococcemia or tuberculosis, about a potential for contracting the disease as a result of exposure. On the other hand, no presumption of a legal duty has until recently existed for infectious but noncontagious diseases, such as Rocky Mountain spotted fever.In a 1993 decision, the Tennessee Supreme Court ruled that a physician treating a patient with documented or suspected Rocky Mountain spotted fever has a legal duty to warn identifiable third parties in the patient's immediate family about the risk of contracting the disease.1 Clustering of Rocky Mountain spotted fever and the simultaneous illness in the family have been reported in a small number of cases.2,3 Of note, major internal medicine and infectious diseases textbooks do not mention either family clustering or duty to

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