Rocky Mountain Spotted Fever

What is Rocky Mountain spotted fever (RMSF)?
RMSF is the most severe tick-borne rickettsial illness in the United States.  This disease is caused by a bacterial infection that is transmitted to people by tick bites. RMSF can be difficult to diagnosis in the early stages. Without prompt and appropriate treatment it can be fatal. It is a seasonal disease that occurs throughout the United States during the months of April through September.

Where does it occur?
Over half of the cases occur in South-Atlantic region of the United States. The highest incidence rates have been found in North Carolina and Oklahoma ( for incidence rates).
How is RMSF spread?
The organism that causes RMSF is transmitted by the bites of an infected tick. The primary ticks that cause the spread are the America Dog tick and Rocky Mountain Wood tick. It is not contagious from person to person.
Signs and symptoms
The classic triad of findings for this disease is fever, rash, and a previous tick bite.
Initial signs and symptoms:

  • Fever (103 degrees Fahrenheit to 105 degrees Fahrenheit)
  • Rash
  • First appears 2 to 5 days after the onset of fever
  • Begins as small, flat, pink, non-itchy spots on the wrists, forearms, and ankles
  • Spots turn pale when pressure is applied and eventually become raised on the skin
  • For pictures of rash:
  • Nausea
  • Vomiting
  • Severe headache
  • Muscle pain
  • Lack of appetite

Later signs and symptoms:

  • Rash
    • The characteristic red, spotted rash is usually not seen until the 6th day or later
    • Occurs only in 35% to 60% of patients
  • Abdominal pain
  • Joint pain
  • Diarrhea

Appropriate antibiotic treatment should be initiated immediately. Standard duration of treatment is 5 to 10 days. If patient is treated within the first 4 to 5 days of the disease, fever usually subsides within 24 to 72 hours.

  • Avoiding tick bites by limiting exposure reduces the likelihood of infection
  • Removing attached ticks promptly
  • Getting early diagnosis and treatment
  • Wear light colored clothing with a tight weave
  • Always wear enclosed shoes
  • Wear long pants tucked in the socks and long sleeved shirts tucked into pants
  • Use an environmental protection agency (EPA) approved tick repellent
  • Keep long hair pulled back
  • Avoid sitting directly on the ground
  • Stay on cleared, well-worn trails when possible
  • Spot-check yourself and others frequently for ticks on clothes
  • Remove clothes after leaving tick-infected areas
  • Conduct a full-body check of yourself, your children, and any outdoor pets from head to toe before going to bed each night
  • Be sure to check the scalp, behind the head and neck, in the ears, and behind any joints

For further information on how to prevent tick bites, and proper removal of ticks:

For additional information about Rocky Mountain spotted fever:

For further information about insect repellents:
How to Properly Remove a Tick

  1. Use fine-tipped tweezers or notched tick extractor. Protect your fingers with a tissue, paper towel, or latex gloves. Do not use bare hands with removing a tick.
  2. Grasp the tick as close to the skin surface as possible and pull upward with steady and even pressure. Don’t twist or jerk the ticks because this may cause the mouthparts of the tick to break off and remain on the skin.
  3. Disinfect the bite site with alcohol and wash your hands with soap and water.
  4. Don’ squeeze, crush, or puncture the body of the tick because its body fluids may contain infectious organism.
  5. Save the tick in cause you become ill for the doctor can identify it and make an accurate diagnosis.


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