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Epidemiology
Rat Bite Fever (RBF) is a zoonotic disease. It can be directly transmitted by rats, gerbils, and mice (the vectors) to humans by either a bite or scratch or it can be passed from rodent to rodent. The causative bacterial agent of RBF has also been observed in squirrels, ferrets, dogs, and pigs. The most common reservoir of the disease is rats because nearly all domestic and wild rats are colonized by the causative bacterial agent, Streptobacillus moniliformis. Most notably, the Black rat (Rattus rattus) and the Norwegian rat (Rattus norvegicus) are recognized as potential reservoirs due to their common use as laboratory animals or kept as pets. It is estimated that 1 in 10 bites from a rat will result in developing RBF. A person is also at risk of acquiring the bacteria through ingestion of contaminated water or food by rodent feces, though this is referred to as Haverhill Fever.

Researchers are challenged in knowing the prevalence RBF. One factor that limits the known number of cases of RBF is that it is not a reportable disease. Rat-Bite Fever is classified as a notifiable disease, which means it is required by the state to be reported, however, the state is not mandated to provide that information to the CDC at the federal level. Identification of RBF is also hindered due to the presence of two different etiological bacterial agents, Streptobacillus moniliformis and Spirillum minus. RBF caused by ''Sp. minus is more commonly found in Asia and is termed Sodoku, whereas St. moniliformis'' is found more often in the United States and in the Western Hemisphere. Although cases of RBF have been reported all over the world, the majority of cases that have been documented are caused by St. moniliformis primarily in the United States, where approximately 200 cases have been identified and reported. Due to increasing population density, this illness is being seen more frequently, as humans have increased their contact with animals and the zoonotic diseases they carry. Most cases of the disease have been reported from densely populated regions, such as big cities. The populations at risk have broadened due to the fact that domestic rats have become a common household pet. In the United States it is estimated that children 5 years and younger are the most at risk, receiving 50% of the total exposure, followed by laboratory personal and then pet store employees. Other groups at increased risk are people over 65 years old, immunocompromised individuals, and pregnant women.

Symptoms of RBF include sudden high temperature fevers, vomiting, headaches, painful joints/arthritis, and a rash that develops 2-10 days after infection. While symptoms differ between Streptobacillary and Spirillary RBF, both types exhibit an incubation period before symptoms manifest. Due to its symptoms, RBF is often misdiagnosed by clinicians, leading to lingering symptoms and worsening conditions in patients; left untreated the mortality rate (death rate) of RBF is 13%. Even when treated, RBF can lead to migratory and chronic arthritis which can persist for weeks to years after initial infection and treatment.