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Rocky Mountain spotted fever is fatal in 2 to 7 percent of cases, primarily because of the delay in diagnosis and initiation of treatment.
Mediterranean spotted fever , or boutonneuse fever, is the most common imported rickettsial disease in returning travelers.
Rocky Mountain spotted fever is endemic in North, Central, and South America.
Continental Europe also has its share of endemic arthropod borne infections, from leishmaniasis and Mediterranean spotted fever in southern France, Italy, and Spain, to tick borne encephalitis in the Baltic states.
Rocky Mountain spotted fever is relatively common and can be severe, especially in children, if the diagnosis is not made quickly.
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