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Rocky Mountain spotted fever (RMSF) is a bacterial illness caused by Rickettsia rickettsii (R. rickettsii). This serious disease is transmitted through the bite of an infected tick. Key symptoms of RMSF include a high fever and headache, with a rash that may appear three or more days after the initial symptoms. Without prompt antibiotic treatment, RMSF can be life-threatening. This disease is present in most states across the U.S.
Who is at risk for RMSF?
Individuals residing in or travelling to regions where ticks are common, especially in the southeastern and south-central United States, are at risk for Rocky Mountain spotted fever. However, the RMSF disease can also be transmitted by ticks found in the Northeast, Pacific Coast, and other regions.
Rocky Mountain Spotted Fever Symptoms
The symptoms of Rocky Mountain spotted fever typically begin two days to two weeks after a bite from an infected tick. These symptoms generally develop progressively over a few days and include fever, headache, nausea, vomiting, and muscle pain.
Approximately 50% of individuals develop a rash within three days. It is important not to wait for the rash to seek treatment.
Symptoms of Rocky Mountain spotted fever include:
- High fever
- Headache
- Loss of appetite
- Muscle pain or soreness
- Rash, usually starting on the wrists and ankles and spreading to other parts of the body
- Nausea and vomiting
- Stomach pain
- Sensitivity to light (photophobia)
Later, more severe rickettsiosis symptoms can include:
- Confusion
- Shortness of breath (dyspnea)
- Anxiety, nervousness, or agitation
- Seizures
- Numbness or weakness
Treatment depends on the individual's RMSF symptoms, age, and general health, as well as the severity of the condition. The typical treatment approach involves administering antibiotics, most commonly doxycycline, and continuing the treatment for several days after the fever has resolved. Additional efforts to alleviate rickettsiosis symptoms are also beneficial.
Rocky Mountain Spotted Fever Causes
Rocky Mountain Spotted Fever (RMSF) is caused by the bacterium Rickettsia rickettsii (R. rickettsii), which is transmitted to humans through tick bites.
In the western United States, the bacteria are carried by the wood tick, while in the eastern United States, they are carried by the dog tick. Infections in the southern United States, Central America, and South America are spread by other types of ticks.
Despite its name, "Rocky Mountain," most recent RMSF cases have been reported in the eastern United States, particularly in North and South Carolina, Virginia, Georgia, Tennessee, and Oklahoma. The majority of cases occur in the spring and summer, predominantly affecting children.
Risk factors include recent hiking or exposure to ticks in areas where the disease is prevalent. Transmission of the bacteria is unlikely if a tick has been attached for fewer than 20 hours. The prevalence of the bacteria in ticks is relatively low, with approximately one in every thousand ticks being carriers. Additionally, bacteria can infect people who crush ticks removed from pets with their bare fingers. Not everyone will recall being bitten by a tick.
Diagnosis of Rocky Mountain Spotted Fever
Diagnosis of Rocky Mountain spotted fever is based on symptoms and a history of a tick bite. The appearance of the rash plays a crucial role in diagnosis. Skin samples and laboratory tests are typically conducted to rule out other conditions and confirm the diagnosis.
Treatment of Rocky Mountain Spotted Fever
The treatment for RMSF fever involves antibiotics, usually taken for seven to ten days. The treatment is most effective when initiated within five days of the onset of symptoms. Delaying antibiotic treatment can lead to severe bodily damage and potentially life-threatening complications.
Additional RMSF treatments may be necessary if complications arise. These treatments could include blood transfusions, mechanical ventilation, or other therapies.
Medications for Rocky Mountain Spotted Fever
There is hardly any vaccine to prevent or cure Rocky Mountain Spotted Fever. However, Doxycycline is the primary antibiotic recommended for treating Rocky Mountain spotted fever. For those allergic to doxycycline, chloramphenicol may be used as an alternative. Nevertheless, Chloramphenicol may not be readily available in certain countries and is generally less effective than doxycycline for treating Rocky Mountain Spotted Fever (RMSF).
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