Since the 1920's the United States Center for Disease Control and Prevention has deemed<unk><unk><unk>  fever (RMSF) as a reportable disease. RMSF cases were most often reported within the<unk><unk>  region, although recent data reveals that the disease is widespread throughout the United States. Areas that currently harbor the majority of RMSF infections are Oklahoma, Tennessee, and Arkansas. The disease has also been reported throughout the Western Hemisphere.  Incidence is highest among children the between the ages of 5-9 years and adults between the ages of 40-64 years. Fatality rates are also higher among these groups, with the highest fatality rate in the elderly at 60 years or more. In terms of demographics,<unk><unk><unk>  fever has been reported at higher rates among males, especially of White and Native American descent.
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