Rickettsial diseases are infections caused by Rickettsia, Orientia, Anaplasma, Ehrlichia, Neoehrlichia, and Neorickettsia species, transmitted through arthropod vectors [1]. These illnesses are globally distributed, though particular species are regionally significant [1].
Disease overview
Bacterial Evidence-backed information EN 5/7 applicable sections · ZH 5/7 applicable sections Updated Oct 23, 2026
Rickettsial diseases are infections caused by Rickettsia and related genera that occur worldwide, with certain species of regional importance [1]. Travelers, particularly long-term travelers, expatriates, and adventure tourists, face elevated exposure risk through arthropod vectors [1]. Rocky Mountain spotted fever is the most common rickettsial disease in the United States, with a mortality rate of 5 to 10 percent [2].
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Classic presentation of Rocky Mountain spotted fever includes fever, headache, and rash in persons with tick bite or exposure history [2]. Other severe dermatologic manifestations associated with rickettsial disease include life-threatening conditions such as Rocky Mountain spotted fever within the broader category of emergent skin disorders [2].
All age groups are at risk for rickettsial infections during travel to endemic areas, affecting both short- and long-term travelers [1]. Risk of transmission increases for travelers engaged in outdoor activities, those near wild or domestic animals, and during peak vector feeding periods, though infections can occur year-round in many regions [1]. The incubation period is generally 5–10 days, with symptoms appearing during travel or within 1–2 weeks after return [1].
Rickettsial pathogens are transmitted to humans through bites or contact with infected arthropod vectors including ticks, fleas, lice, and mites [1]. Exposure risk is heightened by close proximity to animal hosts and participation in outdoor activities where vector contact is likely [1].
No vaccine exists for rickettsial infections, and antibiotics are not recommended for prophylaxis or for asymptomatic persons after suspected exposure [1]. Prevention centers on avoiding arthropod bites through use of approved repellents on skin and clothing, wearing protective garments, and self-examination after visiting vector-infested areas [1]. Minimizing close contact with animal hosts such as rodents, free-roaming dogs, and wildlife further reduces risk, with heightened precautions advised for immunocompromised travelers [1].
- 1 US Centers for Disease Control and Prevention. Rickettsial Diseases | CDC Yellow Book⢠[Internet]. cited 23 Oct 2026. Available from: https://www.cdc.gov/yellow-book/hcp/travel-associated-infections-diseases/rickettsial-diseases.html
- 2 Usatine RP et al. Dermatologic emergencies. Am Fam Physician. 2010 Oct 1. PMID: 20879700. PubMed: https://pubmed.ncbi.nlm.nih.gov/20879700/
- A79
- 1C30
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Recent related research
Outbreak of Brazilian Spotted Fever, Southeastern Brazil, 2018.
Emerging infectious diseases
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Vaccine
Acute febrile illness surveillance using TaqMan Array Cards in two urban health facilities, Monrovia, Liberia, December 2018–March 2020
PLOS Neglected Tropical Diseases
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