Mediterranean Spotted Fever: Epidemiological Assessment in Spain during the Period 2009-2012

Background: The Mediterranean Spotted Fever (MSF) is a zoonosis, produced by Rickettsia conorii whose vector is Rhipicephallus sanguineus. The aim of this study was to describe the epidemiology in Spain and its Autonomous Communities (AA. CC) and the average cost during the period 2009-2012. Methods: We conducted a retrospective observational study of patients, between 2009-2012, whose diagnostic at hospital discharge was encoded, according to the International Classification of Diseases 9th revision Clinical Modification (ICD-9CM) as 82.1 (MSF). The information was collected through the minimum basic data set. Incidence rates of the disease were calculated in Spain and its Autonomous Communities. The fStats software was used for comparison of rates based on age, sex, annual, seasonal and AA. CC's distribution. The average cost (in euros) was calculated according to the state standard. Results: The incidence rate was 0,36 cases per 100,000 inhabitants and year during 2009-2012, with 667 admissions. The highest incidence was obtained in Ceuta and La Rioja with an incidence of 1,9 and 1,87 cases per 100,000 inhabitants per year. No cases were detected in Cantabria nor Canarias. The relative risk male female was 2: 1 (p value< 0,05). The predominant age group was over 55 years (327 cases). The months with the most cases were from June to September (466 cases), producing a peak in the number of cases in August (137 cases). The mortality rate was 0,3%. The average cost was 4.647,205(sic). Conclusion: The incidence of MSF was low, with a heterogeneous geographical distribution and with higher frequency during the month of August. Patients of all ages were detected, predominantly for males over 55 years old. The hospital mortality rate was small.