Cases of African tick bite fever have been more frequently reported in the literature among international travelers.[7] Data examining rates in local populations are limited.[7] Among locals who live in endemic areas, exposure at a young age and mild symptoms or lack of symptoms, as well as decreased access to diagnostic tools, may lead to decreased diagnosis.[20] In Zimbabwe, where R. africae is endemic, one study reported an estimated yearly incidence of 60-80 cases per 10,000 patients.[7][20]