Rocky Mountain Spotted Fever

Rocky Mountain spotted fever occurs mainly in the southeast and south central part of the US. It is found most often in Oklahoma and North Carolina. It is more common in the spring and summer. The organism that causes the fever is transmitted to humans through the bite of a tick. The species of tick involved may vary, depending on the location.

The time from tick bite to symptoms of Rocky Mountain spotted fever ranges from 2 days to 2 weeks. The typical symptoms include:

• fever
• headache
• rash
• muscle aches
• nausea and vomiting
• confusion

The rash starts on the ankles and wrists, then spreads to the palms and soles, and finally to the abdomen and trunk.

When an infected tick bites or burrows into a person's skin, the infection can be spread. The tick may be seen in any area, urban or rural, with heavy brush. This infection may also be spread by blood transfusion from an infected person.

The best way to reduce the risk of Rocky Mountain spotted fever is to reduce exposure to ticks. This can be done by:

• avoiding tick-infested areas
• wearing protective clothing
• using insect repellents
• inspecting the body for ticks after spending time outdoors
• promptly removing attached ticks

Currently there is no reliable test for diagnosing Rocky Mountain spotted fever, so diagnosis is made on the basis of symptoms and the history. The season of the year and where the person has been recently are taken into account. After the acute phase of the disease, blood test called an antibody titer can be done to measure antibodies to the organism in the person's blood. At times a skin biopsy may be done to identify the infecting organism.

If treatment is not started early in a person with Rocky Mountain spotted fever, there may be complications. Long-term effects may involve the brain and spinal cord, causing pain, one sided muscle weakness, or deafness.

Serious complications include blood clotting problems and low blood pressure, both of which can lead to death. Long-term effects, including death and neurologic damage, are not uncommon in severe cases of Rocky Mountain spotted fever.

Rocky Mountain spotted fever is acquired by a tick bite. It is not spread directly from person to person.

Early treatment is crucial for Rocky Mountain Spotted Fever. Treatment includes:

• antibiotics, such doxycycline (i.e., Adoxa, Doryx, Oracea, Periostat, Vibramycin), tetracycline (i.e., Sumycin)
• close monitoring

Possible side effects of doxycycline and other antibiotics include stomach upset, allergic reactions, and liver problems. These antibiotics may also cause discoloration of the teeth in children less than 8 years old or if given in high doses for prolonged periods.

The earlier treatment is started for Rocky Mountain spotted fever, the shorter the recovery time. Bed rest may be needed for several days to several weeks. Activity can be gradually increased slowly as recovery progresses.

Most patients with the full clinical presentation of the disease are hospitalized, occasionally in the intensive care unit.