The disease occurs in sub-Saharan Africa, the West Indies, and Oceania.[1][5] It is relatively common among travelers to sub-Saharan Africa.[2] Most infections occur between November and April.[1] Outbreaks of the disease may occur.[3] The earliest descriptions of the condition are believed to be from 1911.[2] African tick bite fever is a type of spotted fever.[5] It has previously been confused with Mediterranean spotted fever.[2]