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Rare Diseases of Public Health Significance


Rare diseases of public health significance are defined as diseases or conditions of general public health concern, which are not commonly diagnosed in Washington residents.

African Tick Bite Fever

Cause: Rickettsia africae.

Illness and treatment: Symptoms include fever, skin ulcers and swollen lymph nodes. Treatment is with antibiotics.

Sources: Certain hard tick species transmit the disease from various mammals in sub-Saharan Africa.

Prevention: During outdoor activities in endemic areas, wear appropriate clothing, use repellents and check the body for ticks.

Recent Washington trends: Two state residents were infected in South Africa in 2005.

2008: One case was reported in a state resident after travel to South Africa.

Babesiosis

Cause: Parasites in the genus Babesia; at least two types occur in Washington.

Illness and treatment: Symptoms include fever, chills, muscle aches, fatigue, jaundice, and hemolytic anemia. Treatment is with both antibiotics and antiparasitic medications.

Sources: The deer tick, Ixodes scapularis, transmits the disease from rodents. Ixodes ticks occur in wooded, brushy, or grassy areas worldwide. Transmission from infected blood donors and from mother to infant has been described but cases are extremely rare.

Prevention: During outdoor activities in endemic areas, wear appropriate clothing, use repellents and check the body for ticks.

Recent Washington trends: Very few cases have been reported in Washington, though occasionally up to 2 cases are reported annually. Most are acquired during out of state travel.

2008: One case was reported in a state resident after travel to Massachusetts.

Coccidioidomycosis (Valley Fever)

Cause: The soil fungus Coccidioides immitis.

Illness and treatment: Symptoms include fever, cough, headache, rash, and muscle aches. Treatment is with antifungal drugs.

Sources: Exposure to airborne fungal spores with disruption of contaminated soil in semiarid areas such as southwestern United States, parts of Mexico and South America.

Prevention: Avoid exposure to dusty environments in endemic regions.

Recent Washington trends: Since 2006, Washington has had up to two cases each year.

2008: One case was reported in a state resident after travel to Arizona.

Creutzfeldt-Jakob Disease (CJD)

Cryptococcosis

Ehrlichiosis

Cause: Bacteria in the genus Ehrlichia.

Illness and treatment: Usual symptoms are fever, headache and muscle aches. There may be vomiting, diarrhea, cough, joint pains, confusion, and rash. Treatment is with antibiotics.

Sources: Certain hard ticks, mainly the Lone Star tick, transmit from animal reservoirs such as deer, dogs, and rodents. Most cases in the United States are in the southern, eastern, and south-central states.

Prevention: During outdoor activities in endemic areas, wear appropriate clothing, use repellents and check the body for ticks.

Recent Washington trends: Rare cases of travel-associated ehrlichiosis are reported.

2008: No cases were reported.

Rocky Mountain Spotted Fever

Cause: Rickettsia rickettsii.

Illness and treatment: Symptoms include fever, rash, diarrhea, vomiting, muscle and joint pain, abdominal pain, lack of appetite, and severe headache. Treatment is with antibiotics.

Sources: Certain hard tick species (American dog tick and Rocky Mountain wood tick) found in the United States including in Washington transmit the disease to vertebrates. These ticks live in woodlands, grasslands, and shrubs between wetlands and woods.

Prevention: During outdoor activities in endemic areas wear appropriate clothing, use repellents and check the body for ticks.

Recent Washington trends: Annually, 0 to 3 cases are reported.

2008: 3 cases were reported with potential exposures were in Idaho, Canada, and eastern Washington or Yellowstone, Montana.

Tick Paralysis

Cause: A tick-produced neurotoxin affecting the nervous system.

Illness and treatment: Cases have acute, ascending, flaccid paralysis. If unrecognized, tick paralysis can progress to respiratory failure. About 10% of cases are fatal. Treatment requires removing the tick; complete recovery usually follows.

Sources: Neurotoxin produced by certain hard ticks is usually released only after a tick has attached to a person for several days. The Rocky Mountain wood tick and the American dog tick are two species found in Washington that are associated with tick paralysis.

Prevention: During outdoor activities in endemic areas wear appropriate clothing, use repellents, and check the body for ticks, especially on the head or neck.

Recent Washington trends: Occasional cases are reported from eastern Washington, most often in young girls whose long hair conceals attached ticks.

2008: One case was reported in an adolescent boy who acquired a tick in Kittitas County.

Purpose of Reporting and Surveillance

  • To understand the epidemiology of emerging and uncommon diseases in Washington State.
  • To raise the index of suspicion of a possible bioterrorism event.

Legal Reporting Requirements

  • Health care providers: immediately notifiable to local health jurisdiction.
  • Hospitals: immediately notifiable to local health jurisdiction.
  • Laboratories: no requirements for reporting.
  • Local health jurisdictions: immediately notifiable to the Washington State Department of Health (DOH) Communicable Disease Epidemiology Section (CDES):
    1-877-539-4344

Last update
November 2009

Rare Diseases Resources

Reporting Forms

Rare Diseases Reporting Form
(PDF Format)

Public Health and Health Care

Surveillance and Reporting Guidelines
(PDF format)
Monkeypox
Case investigation form
(PDF format)
Case investigation guidelines
(PDF format)

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Communicable Disease Epidemiology
Office of Epidemiology
Washington State Department of Health
MS: K17-9, 1610 NE 150th St.
Shoreline, WA 98155-9701

Consultation and technical assistance are available to local health jurisdictions in Washington State:
Phone (206) 418-5500

FAX (206) 418-5515

24-hour contact (inside Washington State only)  1-877-539-4344

Washington residents can contact their local health jurisdictions for assistance


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