Epidemiology of Rocky Mountain spotted fever in South Carolina, 1985-1990.

By analyzing three different sources of data including DHEC reported cases, hospital discharge data, and death certificates, our study reveals that RMSF is endemic in South Carolina particularly in the Piedmont area and that underreporting of RMSF in South Carolina is likely. The incidence and case fatality rates of RMSF derived from hospital discharge data are higher than these rates derived from cases reported to DHEC. Physicians should be aware of the endemicity of RMSF in South Carolina and should include it in the differential diagnosis of any case of fever of unknown origin especially during the spring and summer seasons regardless of the history of a tick bite.