Table 1 Study inclusion criteria
Criterion number | Description of criterion | Rationale |
|---|---|---|
1 | Presented to frontline provider during the period March 2019 to February 2020 or March 2020 to February 2021 | One year prior to and 1 year after onset of pandemic |
2 | Age ≥ 18 years | Focus on adults only given presumed greater COVID-19 impact |
3 | Acute Rickettsia rickettsii or Ehrlichia serology performed within 14 days of symptom onset and convalescent serology performed within 14–70 days of acute serology, with fourfold change in titer between serologies | Individuals with confirmatory laboratory evidence |
4 | At least 2 clinical symptoms suspicious for TBD (e.g., fever, headache, rash or eschar, arthralgia or myalgia, nausea, vomiting, or diarrhea) and present for ≤ 14 days | Clinical presentation consistent with acute TBD infection |
5 | A single R. rickettsii or Ehrlichia test with a titer ≥ 1:256 | Individuals with presumptive laboratory evidence |
6 | At least 1 R. rickettsii or Ehrlichia test without symptoms present for ≤ 14 days | Individuals with suspected TBD infection |
7 | No testing done and a leading diagnosis of TBD and a prescription of doxycycline | Individuals treated empirically |