A Multiple-Serotype Outbreak of Infections Linked to Kratom, United States, 2017-2018.

In early 2018, we investigated a large national multiple-serotype outbreak linked to contaminated kratom, a raw minimally processed botanical substance. Kratom is a plant consumed for its stimulant effects and as an opioid substitute. A case was defined as a laboratory-confirmed infection with one of the outbreak strains (serotypes I 4,[5],12:b:-, Heidelberg, Javiana, Okatie, Weltevreden, or Thompson) with illnesses onset during January 11, 2017-May 8, 2018.

Multistate Survey of American Dog Ticks () for Species.

, a common human-biting tick found throughout the eastern half and along the west coast of the United States, is a vector of multiple bacterial pathogens. Historically, has been considered a primary vector of , the causative agent of Rocky Mountain spotted fever. A total of 883 adult , collected between 2012 and 2017 from various locations in 12 states across the United States, were screened for rickettsial DNA.