This disease is found throughout the world, but is more commonly found throughout the tropics, subtropics, and in port cities and costal regions. Risk of infection increases with exposure to flea infested dogs and cats and sleeping in rodent infested areas. Symptoms of this disease include fever, headache, malaise, rash, nausea, and vomiting. Diagnosis of cat flea rickettsiosis can be difficult, even for doctors who diagnosis this disease more frequently. Diagnosis must be made by a healthcare practitioner who will base diagnosis on clinical recognition and serology. Treatment should be started immediately and should never wait for confirmatory testing. There is no preventative medication or vaccine available.