摘要:What is already known about this topic? Spotted fever rickettsioses (SFR) are nationally notifiable diseases caused by spotted fever group Rickettsia. SFR incidence has steadily increased since 2000; however, the majority of cases fail to meet criteria for confirmation. What is added by this report? A total of 16,807 SFR supplemental case report forms were provided to CDC with illness onset during 2010–2015; 1.0% met criteria for confirmation. Reasons for nonconfirmation included failure to submit a second serum specimen and low use of molecular diagnostic techniques. What are the implications for public health practice? Increased use of molecular assays, collecting appropriately timed serum specimens, and elimination of unreliable laboratory criteria could be important for understanding trends in SFR epidemiology in the United States.