When we think of tick bites, Rocky Mountain spotted fever isn’t the first infection that comes to mind though it can cause a potentially serious or fatal illness. Rocky Mountain spotted fever (RMSF) is caused from the bite of a tick that has been infected with the bacteria called Rickettsia rickettsii. The ticks are most active during April to September and despite the name, the illness can occur all over the U.S.
The most common states that RMSF occurs in are Oklahoma and North Carolina with South Carolina, Tennessee, and Georgia being the next group of high incidence states. (2)
Signs and symptoms:
A person infected with the R. rickettsii will typically develop symptoms within a week of being bitten by the infected tick. People usually go to their doctor with complaints of multiple symptoms such as headache, fever, rash and muscle pain. Nausea and vomiting may also be present and 25 percent of people develop symptoms of lethargy or confusion. RMSF can be difficult to diagnose so it is important to relay any possible exposure to ticks from outside activities. Not everyone will notice if they have a tick bite or develop the rash.
Approximately 85-90 percent of patients will develop a spotted rash often after the other symptoms of headache, fever and GI complaints have appeared. The rash usually first appears around the wrists and ankles and 43 percent of people will later develop it on the palms of their hands or soles of their feet. The rash starts out splotchy with small macules that spread to becoming spotted and itchy. (2)
Diagnosis of RMSF is made by symptoms, history of a tick bite and lab tests that confirm low platelet counts, low sodium levels and elevated liver enzymes. According to Illinois Dept of health, “Overall mortality hovers between 3 percent and 5 percent but ranges from 13 percent to 25 percent in untreated individuals.” (4) The death rate is highest in those who delayed seeking medical attention until the second week of their illness. RMSF is not an illness to ignore.
How it is treated:
Patients are given a tetracycline type drug or doxycycline for 5 to 10 days either orally or intravenously and they are closely monitored for a reduction of their fever. All medication must be taken as prescribed by the doctor for the entire length of time ordered to ensure the infection has been treated.
Prevention:
• Vigilance in preventing ticks from attaching to clothes or skin as well as meticulous checking after a possible exposure is the best way to prevent getting RMSF or any tick borne illness.
• Wear light colored clothes, long sleeve shirts and pants when hiking. Tucking the pants into socks and boots will prevent ticks from slipping inside.
• Use of repellents containing DEET (30 percent or less) prior to hiking is recommended with washing of treated skin after returning indoors.
• Check yourself, your children, and your pets after a day of outside activities for any suspicious bites. Pets may need additional tick protection treatment as recommended by your veterinarian.
• Rocky Mountain fever is not a common illness, only about 250 to 2,000 cases per year occur in the United States but it is important to seek medical care, especially if children are involved, for any potentially tick related illnesses. (5)
Sources:
1. Rocky Mountain Spotted Fever. MedicineNet.com. Web. 4 Aug. 2011.
http://www.medicinenet.com/rocky_mountain_spotted_fever/article.htm
2. Tick-Borne Diseases, Rocky Mountain Spotted Fever. Medscape Reference. Web 4 Aug. 2011 http://emedicine.medscape.com/article/785659-overview
3. Rocky Mountain spotted fever: MedlinePlus Medical Encyclopedia. National Library of Medicine - National Institutes of Health. Web. 4 Aug. 2011. http://www.nlm.nih.gov/medlineplus/ency/article/000654.htm
4. ROCKY MOUNTAIN SPOTTED FEVER. Illinois Department of Public Health Home Page. Web. 4 Aug. 2011. http://www.idph.state.il.us/public/hb/hbrmsf.htm
5. Infections- Rocky Mountain Spotted Fever. Kidshealth from Nemours. Web. 4 Aug. 2011. http://kidshealth.org/parent/infections/bacterial_viral/rocky.html
Edited by Jody Smith
Michele is an R.N. freelance writer with a special interest in woman’s healthcare and quality of care issues. Other articles by Michele are at www.helium.com/users/487540/show_articles