Spotted Fever Group Rickettsioses among Hospitalized Patients and Circulation of <i>Rickettsia</i> in Ticks, Kazakhstan, 2019

Testing for spotted fever group rickettsioses (SFGR) and the criteria for identifying suspected patients are not routinely used in Kazakhstan. In 2019, we performed a cross-sectional study in 6 sentinel hospitals in the Pavlodar region. We tested 105 hospitalized patients with SFGR-like symptoms by using PCR or indirect immunofluorescence antibody assay and identified 62 cases of SFGR. Most (78%) cases of disease were caused by Rickettsia sibirica and R. raoultii. Cutaneous signs (eschar or rash) were found in 87% of SFGR patients; 79% had a rash, 48% had an eschar, and 13% had neither. Testing of suspected rickettsia cases resulted in a 27% increase in laboratory-detected SFGR over the mean of the previous 3 years (62 vs. 49). Broadening the case definition by including fever, headache, or myalgia and expanding routine testing for suspected cases of SFGR could contribute to improved case detection and earlier treatment.