Although the “rickettsiosis” reported in Michoacan could represent Rocky Mountain spotted fever, the extent and location of this outbreak suggests a diagnosis of Endemic typhus. In the following graph, I’ve compared the incidence of these two diseases in Mexico.

In fact, six Rickettsiae (including Coxiella burnetii, a related taxon) are reported in Mexico. The following summary is abstracted from Gideon www.GideonOnline.com and references 1-3. (primary references available on request)

Rickettsia felis:
Rickettsia felis infection was first identified in the Yucatan in 1996, where the organism has subsequently been identified in both humans and fleas.
- Infected fleas have also been recovered from flying squirrels in Mexico.
- Four cases were documented in the Yucatan to 2006.
- Eight cases (3 fatal) of “spotted fevers” were reported in the Yucatan during 2006 to 2007.
Prevalence surveys:
20% of Ctenocephalides felis fleas in Yucatan (2002 publication)
Seroprevalence surveys:
5% of healthy persons in Yucatan (1999)

Epidemic typhus:
– 7,353 fatal cases of epidemic typhus were reported during 1893 to 1907.
– 1,220 cases (707 fatal) were reported during 1939 to 1943.
– The average incidence during 1959 to 1961 was 146 cases per year.
– 64 cases (14 fatal) were reported during 1960 to 1963.
– A total of three outbreaks were reported during the 1980′s – two in Chiapas and one in Mexico State.
Prevalence surveys:
0% of body lice from prisoners and homeless persons in Mexico City (2009 publication)
Notable outbreaks:
1951 – An outbreak (737 fatal cases) was reported.
1966 – An outbreak (10 cases, 0 fatal) was reported in Zoyatlan de Juarez.
1966 to 1967 – An outbreak (18 cases, 3 fatal) was reported in Minas Viejas (Mexico State).
1967 – An outbreak (40 cases, 1 fatal) in Atlacomulco, Mexico State, originated from a patient with Brill-Zinsser disease.
1983 – An outbreak (102 cases, 0 fatal) was reported in Mexico State

Endemic typhus:
Endemic typhus is reported in Guerrero, Hidalgo, Jalisco, Mexico, Michoacan, Nayarit, Nuevo Leon, Oaxaca, Puebla, Quertaro, Tamaulipas, Yucatan and Zacatecas States.
Seroprevalence surveys:
14% to 17% of blood donors in Mexico City (2004 publication)

Rocky Mountain spotted fever
In Mexico, this disease is known as fiebre machada.
– During 1930 to 1950, cases were reported from Coahuila, Durango, San Luis Potosi, Sinaloa and Sonora.
– Rocky Mountain spotted fever has been identified in the Yucatan since 2005.
– Cases continue to occur in Sonora as of 2010
– Mexico’s first fatal case was reported in the southwestern region in 2004.
– 52 cases were reported in Baja California during February to July, 2009.
Prevalence surveys:
40% of patients suspected of having dengue (Yucatan and Jalisco, 1993)
Seroprevalence surveys:
5.6% of persons in rural Yucatan are seropositive toward spotted fever-group rickettsiae (possibly the R. akari group, 1999 publication)
Vectors:
The local vector is Rhipicephalus sanguineus.
- Spotted fever-group rickettsiae have also been isolated from Amblyomma cajennense in Veracruz.
- Amblyomma imitator has been identified as a potential vector in Nueva Leon.
Notable outbreaks:
2009 – An outbreak (4 fatal cases) was reported in Baja California.

Rickettsialpox
– Two cases of rickettsialpox were documented in Yucatan in 2008.
– Evidence of canine infection has been reported in Yucatan (2009 publication)

Q fever:
Seroprevalence surveys:
2% of humans, 2% of cattle and 6% of goats and sheep (1952)
1.46% of cows (1950)
28% of the dairy cattle, 10% of beef cattle, 35% of goats and 40% of sheep (Nueva Leon, 2002 publication)

References:
1. Berger S. Infectious Diseases of Mexico, 2011. 446 pp, 128 graphs, 1,655 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-mexico/
2. Berger S. Endemic Typhus: Global Status, 2011. 65 pp, 90 graphs, 83 references. Gideon e-books,
http://www.gideononline.com/ebooks/disease/epidemic-typhus-global-status/
3. Graph tutorial at: http://www.GIDEONonline.com/wp/wp-content/uploads/Gideon-Graphs.pps

Note featured on ProMED

Notwithstanding a recent series of outbreaks, rates of Hepatitis A in Mexico have changed little since 1984, and remain similar to those reported in the United States during the 1960′s and 1970′s (see graph). [1-3]

References:
1. Berger SA. Infectious Diseases of Mexico, 2011. 446 pp, 128 graphs, 1655 references. Gideon e-book series, http://www.gideononline.com/ebooks/country/infectious-diseases-of-mexico/
2. Berger SA. Hepatitis A: Global Status, 2011. 163 pp, 180 graphs, 1073 references. http://www.gideononline.com/ebooks/disease/hepatitis-a-global-status/
3. http://www.GIDEONonline.com/wp/wp-content/uploads/Gideon-Graphs.pps
Featured in ProMED

Mexico is one of relatively few countries which publish rates of scabies on a national level. A recent outbreak in Veracruz belies the fact that infestation rates have been steadily declining since the 1980′s (see graph). [1,2]

References:
1. Berger SA. Infectious diseases of Mexico, 2011. 446 pp, 128 graphs, 1655 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-mexico/
2. Berger SA. Arthropod Infections: Global Status, 2011. 85 pp, 70 graphs, 242 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/arthropod-infections-global-status/

Featured in ProMED

Mexico is one of only eight countries which mandate reporting of cysticercosis on a national level. The following background data are abstracted from the Gideon e-book series. [1,2]

Cysticercosis in Mexico: Incidence and rates per 100,000, see graph:

Prevalence surveys:
Neurocysticercosis is found in 0.4 to 3.5% of autopsies (1980′s) and accounts for 25% of cerebral mass lesions.
Cerebral cysts are identified in 50% of late-onset epileptics (1990)
Six percent of cerebral CT scans are positive for this disease (Yucatan, 1989 to 1994).
0.49% of the Indian rural population of Chiapas are seropositive (1976 publication)
1.5% of persons in the Yucatan are infested by Taenia solium, and 3.7% are seropositive toward the parasite (1996 to 1997).
1.2% of persons in rural Guererro are infested and 3.26% are seropositive (1998)
0.5% of military personnel in Mexico City are infested and 12.2% are seropositive (1999 publication)
43.8% of the population of Cuentpec, Morelos are seropositive, and 9% have neurocysticercosis (2006 publication)
12.2% of military personnel in Mexico City are infested by Taenia solium (1999 publication)

Additional notes:
261 fatal cases were reported in 1990; 293 in 1996.
124 fatal cases were reported in California during 1989 to 2000 – of which 72.6% were Mexican immigrants.
Ten percent of Mexican pork is contaminated by Taenia solium – 23% in the Yucatan (1996 to 1997).

References:
1. Berger SA. Infectious Diseases of Mexico, 2011. 446 pp, 128 graphs, 1655 references. Gideon e-book series, http://www.gideononline.com/ebooks/country/infectious-diseases-of-mexico/
2. Berger SA. Cysticercosis: Global Status, 2011. 25 pp, 8 graphs, 261 references. Gideon e-book series, http://www.gideononline.com/ebooks/disease/cysticercosis-global-status/

Mexico offers a useful paradigm for the impact of canine rabies control on human disease. The attached graph contrasts reports of dog rabies vs. rates per 100,000 humans in this country. [1,2]

References:
1. Berger SA. Infectious Diseases of Mexico, 2011. 446 pp, 128 graphs, 1655 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-mexico/
2. Berger SA. Rabies: Global Status, 2011. 366 pages, 546 graphs, 1056 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/rabies-global-status/

In recent years, reported rates of trichinosis in Mexico have decreased to levels which are comparable to those of the United States. In fact, Canada now reports the highest rates for North America (see graph). [1,2]

Chronology of trichinosis outbreaks in Mexico (primary reference available on request) [1,2]

Notable outbreaks:
1979 (publication year) – An outbreak was reported among family members in Naucalpan.
1981 (publication year) – An outbreak was reported in Villanueva, Zacatecas.
1984 (publication year) – Outbreaks were reported in Zacatecas.
1985 (publication year) – An outbreak was reported in Zacatecas.
1985 – An outbreak was reported in a government office in Federal District.
1986 (publication year) – An outbreak was reported in Durango.
1990 (publication year) – An outbreak (4 cases) among family members in Iztapalapa was caused by raw sausage.
1992 (publication year) – An outbreak (166 cases) in Delicias City, Chihuaha was caused by contaminated pork sausage.
1992 (publication year) – An outbreak (3 cases) among members of a family in Zapopan was related to consumption of raw pork.
1994 – An outbreak (7 cases) in France was associated with horsemeat imported from Mexico.
2001 (publication year) – An outbreak (5 symptomatic and 17 asymptomatic cases) was reported in Mexico State.

References:
1. Berger SA. Infectious Diseases of Mexico, 2010. 439 pp. Gideon e-books. http://www.gideononline.com/ebooks/country/infectious-diseases-of-mexico/
2. Berger SA. Trichinosis: Global Status, 2010. 81 pp. Gideon e-books. http://www.gideononline.com/ebooks/disease/trichinosis-global-status/

Reports of two recent cases of in Jalisco underline the fact that rabies is still a problem in this region. Although Mexico has reported 0 to 2 cases yearly since 2000, highest rates in the area are encountered in El Salvador.