Details:

Alternative Title:
Zoonoses Public Health
Personal Author:
Cherry, Cara C. ; Binder, Alison M.
Cherry, Cara C. ; Binder, Alison M. Less -
Description:
Typhus group rickettsioses (TGRs) are vector-borne diseases that include murine typhus (Rickettsia typhi) and epidemic typhus (R. prowazekii). Twentieth-century public health interventions led to dramatic decreases in incidence; little is known about the contemporary TGR prevalence because neither disease is nationally notifiable. We summarized administrative claims data in a commercially insured population to examine trends in TGR medical encounters. We analysed data from 2003 to 2016 IBM® MarketScan® Commercial Databases to identify persons with inpatient or outpatient visits with an International Classification of Diseases, Ninth or Tenth Revision, Clinical Modification TGR-specific code. We summarized epidemiologic characteristics associated with incident diagnosis. We identified 1,799 patients diagnosed with a TGR. Patients resided in 46 states, and most were female (n = 1,019/1,799; 56.6%); the median age was 42 years (range: 0-64 years). Epidemic typhus (n = 931/1,799; 51.8%) was the most common TGRs, followed by murine typhus (n = 722/1,799; 40.1%). The majority of TGR patients were diagnosed in an outpatient setting (n = 1,725/1,799; 95.9%); among hospitalized patients, the majority received a murine typhus diagnosis (n = 67/74; 90.5%). TGRs are rarely diagnosed diseases. More patients were diagnosed with epidemic than murine typhus, even though R. prowazekii transmission requires body louse or flying squirrel exposure. Patients from all geographic regions were diagnosed with murine and epidemic typhus, despite historically recognized ranges for these diseases. The epidemiologic misalignment of insurance claims data versus historic TGRs data highlights the challenges of finding appropriate alternative data sources to serve as a proxy when national surveillance data do not exist.
Subjects:
[+]
Adolescent Adult Child Child, Preschool Databases As Topic Female Humans Infant Insurance, Health Insurance Claim Reporting Male Middle Aged Population Surveillance Rickettsiaceae Time Factors Typhus, Endemic Flea-Borne Typhus, Epidemic Louse-Borne Young Adult
Source:
Zoonoses Public Health. 67(3):291-299
Pubmed ID:
31984654
Pubmed Central ID:
PMC7480083
Document Type:
Journal Article
Funding:
CC999999/ImCDC/Intramural CDC HHS/United States
Place as Subject:
United States
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:351fdfeb2ae3d385958e84550b02a495f8d13b8c57db38b4562325edd98e3112
Download URL:
https://stacks.cdc.gov/view/cdc/93488/cdc_93488_DS1.pdf
File Type:

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