Community-based prevention of Rocky Mountain spotted fever--Sonora, Mexico, 2016.
Domestic dogs serve as primary hosts for Rh. sanguineus ticks and present a unique target for control. Community-based programs for the control of Rhpicephalus-associated RMSF using long-acting tick collars on dogs and environmental acaricides (pesticides targeting ticks) have been found to be effective in reducing tick populations in homes and on dogs and in human disease cases (4). After the successful control of Rhipicephalus-associated RMSF in Arizona during 2012-2013, a collaborative endeavor was initiated in February 2016 among the University of Sonora School of Medicine, the Sonora MOH, and CDC to reduce the number of human RMSF cases in community A.
Over a period of 5 days in March 2016, six teams comprising local health care workers and community leaders, medical students from the University of Sonora School of Medicine, and public health veterinarians and epidemiologists from the Sonora MOH and CDC registered 530 households, provided education on RMSF, and placed tick collars on approximately 750 dogs. A knowledge, attitudes, and practices survey, which focused on understanding of RMSF and awareness and use of preventive practices, also was conducted among 230 households in community A and among 200 households in a similarly affected control community (community B). Community B was geographically removed (>50 km [31 miles]) from community A, and the socioeconomic status of most inhabitants was similar between the communities. In community A, 60% of dogs that were registered had visible tick infestations, and almost half of the participants reported seeing ticks inside their homes. Sonora MOH vector-control operators applied deltamethrin, an environmental acaricide, to the exterior walls and adjacent yard areas of participating homes. Bimonthly follow up visits were made to monitor tick populations on dogs, replace tick collars as necessary, deliver health messages, and provide timely pesticide application. The intervention will end in November 2016.
Since the beginning of the intervention in March through November 14, 2016, no new cases of RMSF have been reported from the intervention area in community A, and three RMSF cases (one fatal) have been reported in community B. In addition, 109 cases, 35 (32%) of which were fatal, have been reported from the remaining areas of Sonora, including two cases (one fatal) in community A outside of the intervention area, indicating that RMSF transmission is continuing in this region of Mexico. Data analyses are ongoing, including analysis of the pre- and postintervention knowledge, attitudes, and practices surveys.
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(4.) Drexler N, Miller M, Gerding J, et al. Community-based control of the brown dog tick in a region with high rates ofRocky Mountain spotted fever, 2012-2013. PLoS One 2014;9:e112368. http://dx.doi.org/10.1371/journal.pone.0112368
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(6.) Dahlgren FS, Holman RC, Paddock CD, Callinan LS, McQuiston JH. Fatal Rocky Mountain spotted fever in the United States, 1999-2007. Am J Trop Med Hyg 2012;86:713-9. http://dx.doi.org/10.4269/ ajtmh.2012.11-0453
Anne Straily, DVM [1,2]; Naomi Drexler, MPH ; Denica Cruz-Loustaunau, MD ; Christopher D. Paddock, MD ; Gerardo Alvarez-Hernandez, MD, PhD 
 Epidemic Intelligence Service, CDC;  Rickettsial Zoonoses Branch, Division ofVector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC;  Secretariat of Public Health, Sonora, Mexico;  Department of Medicine and Health Sciences, University of Sonora, Sonora, Mexico.
Corresponding author: Gerardo Alvarez-Hernandez, email@example.com, 52-662-259-2121.
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|Title Annotation:||Notes from the Field|
|Author:||Straily, Anne; Drexler, Naomi; Cruz-Loustaunau, Denica; Paddock, Christopher D.; Alvarez-Hernandez,|
|Publication:||Morbidity and Mortality Weekly Report|
|Date:||Nov 25, 2016|
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