Rocky Mountain Spotted Fever


Last Updated December 20th, 2021

What is Rocky Mountain spotted fever?

RMSF (Rocky Mountain spotted fever) is a bacterial disease caused by the bite of an infected tick (an arachnid that draws blood from the human body) or by contamination with tick blood or feces. The tick here is infected by bacteria called Rickettsia rickettsii. You are very likely to get the disease if an infected tick bites you and remains on your body drawing blood for 6 to 10 hours. Types of ticks that may be vectors or carriers of RMSF include:

  • American dog tick (Dermacentor variabilis)
  • Rocky Mountain wood tick (Dermacentor andersoni)
  • Brown dog tick (Rhipicephalus sanguineus)

Incidence and Severity

Rocky Mountain spotted fever (RMSF) has been a nationally notifiable illness in the United States since the 1920s. During 2000 to 2007, the cases of RMSF increased from 1.7 to 7 cases per million persons. In clinical reviews of RMSF, it is fatal in about 5-10% of the cases. Around 60% of the cases of RMSF reported in the United States are from five states (North Carolina, Tennessee, Oklahoma, Arkansas, and Missouri). Also, the incidence rate is higher in American Indians than in other ethnic groups within the United States.

The risk to Pregnant Women

A teratogen is anything such as radiation or a drug that can disturb the normal growth of the embryo or fetus. Doxycycline has not been found to cause substantial teratogenic conditions in pregnant women. However, it is advised to offer to counsel to pregnant women before they undertake treatment for RMSF. This will make them more aware of the risks and benefits involved.

Symptoms

  • High fever of 100 to 102 degrees Fahrenheit
  • Headache
  • Nausea
  • Vomiting
  • Fatigue
  • Poor appetite
  • Abdominal pain
  • The rash develops after the bite and over the next 2 to 5 days slowly spreads to the inner torso
  • On the sixth day, the purple-red rash starts to form. This is a serious symptom that warrants an immediate visit to the doctor.

Mortality Rate of RMSF

Overall mortality varies between 3 percent and 5 percent in cases where the treatment is done, but it ranges from 13 percent to 25 percent in untreated individuals. Death primarily occurs in individuals when the diagnosis is made in the second week or later.

Diagnosis and Testing

  • Diagnosis is arrived at based on a person’s symptoms and the possibility of exposure to ticks.
  • Your healthcare provider may order certain blood tests to look for evidence of RMSF. Results may take weeks.
  • Treatment with doxycycline should never be delayed while waiting for diagnostic test results.

Why Diagnosis is Difficult

  • About 10 to 15% of the people do not develop spotted rashes at all.
  • Only about half of the people remember having been bitten by a tick.

Time of Occurrence and Likely Host

RMSF occurs when ticks are most active. This is especially the case during periods of warm weather or between the months April to September. RMSF usually affects people who travel a lot and spend a lot of time outdoors. It could be carried by pets and the tick can be transferred from the pet to the owner when he/she interacts with the pet.

Complications Associated with RMSF

There are several complications associated if RMSF is diagnosed later. They include:

  • Amputation of fingers, toes, arms and/or legs because of gangrene
  • Hearing loss
  • Permanent mental disability
  • Paralysis on one side
  • Feeling restless and being unable to sleep
  • Coma, if the brain blood vessels are affected
  • Inflammation of the airways (pneumonitis) and pneumonia
  • Anemia
  • Heart and kidney damage
  • Severe low blood pressure and death (uncommon, but this may happen when the infection is severe)

Treatment of RMSF

People who become conscious of a tick bite must watch for signs or symptoms of RMSF. Treatment of asymptomatic individuals is not recommended.

Treatment with Doxycycline

Doxycycline is the antibiotic generally used to treat RMSF and all other tickborne rickettsial diseases. Use of antibiotics other than doxycycline could increase the risk of fatality. Presumptive treatment with doxycycline is recommended in most cases, including children less than 8 years of age. Presumptive treatment is the treatment of clinically suspected cases without, or prior to, results from confirmatory laboratory tests. Doxycycline is most effective when started within the first five days of contraction of the illness.

Duration of Treatment and Dosage

When treated with doxycycline, fever generally subsides in 24-48 hours. In severe cases, the fever may take longer to subside, especially if organ damage is involved. Resistance to doxycycline or a relapse of symptoms after treatment has not yet been observed.  The minimum duration of treatment is 5 to 7 days. In patients, where the fever has reduced, it is still advised to continue with doxycycline for 3 more days to ensure that RMSF is cured. The dosage of doxycycline is as follows:

  • Adults: 100 mg every 12 hours
  • Children under 45 kg (100 lbs): 2.2 mg/kg body weight given twice a day.

Treatment with Chloramphenicol

Chloramphenicol is the only other drug that has been found to be effective in the treatment of RMSF. Epidemiologic studies, however, suggest that RMSF patients treated with chloramphenicol run a higher risk for death than people who receive doxycycline. Also, oral formulations for chloramphenicol are not available in the United States and can lead to other medical conditions such as aplastic anemia and grey baby syndrome.

Other Treatment Possibilities

Antibiotics containing chemicals called sulfonamides can trigger an allergic reaction. Therefore, they are not used in the treatment of RMSF. Other antibiotics, including almost all other classes of broad-spectrum antibiotics, are not effective in treating RMSF.

Prevention of RMSF: Eliminating the Ticks

There is no vaccine for RMSF. Post tick bite, the use of antibiotic prophylaxis to prevent RMSF is not recommended. Instead, one must focus on how to eliminate the ticks that are behind RMSF. Ticks live in grassy, wooded regions and most people get it from their own backyard. Be careful around pets that may carry the ticks and also. One can do the following:

When you are Outdoors

Be conscious of your surroundings

Ticks are usually found in grassy or wooded areas. Try to avoid such areas. If you have to venture to such areas when in such areas, be conscious enough to know if you have been bitten by a tick.

Permethrin Treatment

Treat clothing and boots and camping gear with Permethrin. This is a tick-resistant coating that stays on after several washes.

Use of EPA-Approved Insect Repellents

Always only use an EPA-approved insect repellent and follow labeled instructions. These help to keep the ticks at bay. But do not use common insect repellents on children aged 2-3 years of age. Also, do not apply insect repellent on the face, especially around the eyes or mouth.

When you Return Indoors

Check your clothing and gear for ticks

Tumble dry clothing in a dryer at high heat for about 10 minutes to kill ticks that may remain on it. If the clothes are damp, more time may be required. In case you need to wash the clothes, washing them in hot water helps to kill more ticks than using cold or room temperature water.

Check your body for ticks

Check your body for ticks as soon as you return indoors. If found, remove them using the tips mentioned later in this article. They are generally found on the hair, in and around the ears, inside the belly button, the armpits, and between the legs, etc.

Check your pets for ticks

Ticks are generally found on dogs in specific areas of the body. When you return from habitats where ticks are commonly found, you can run a check in these areas. They are the groin, the ears, around the paws, armpits, and in between the toes. Also, discuss with a veterinary doctor before you decide to use insect repellents on your pets. Cats are particularly sensitive to certain insect repellents.

Avoid natural insect repellents in case of allergies

Natural insect repellents like eucalyptus oil and lavender oil are known to cause allergic reactions in pets and people. Also, pennyroyal oil has been associated with seizures and deaths in some pets.

Shower as early as possible

Shower within two hours of returning indoors to ensure that you scrub away any ticks that may be present on your body.

How to Tick-proof your House and Yard

Clear out and demarcate areas of debris or grass

Clear out areas where lawn and tree debris gather. Ticks do not thrive in dry sunny areas but do so in moist and damp areas. Make sure compost piles are located away from play areas. Also, make sure they are separated by wood chips and gravel.

Locate recreational areas away from treed areas

Make sure that playground equipment, decks, and patios are located away from grassy or treed areas.

Clean your house regularly

Keep the house clean by scrubbing and using cleaning agents like bleach. Take special care of the patio and try to use bleach regularly.

Mow the lawn regularly

Mow the lawn regularly and keep it dry and clean. Keep the grass as short as possible, so that ticks cannot thrive in it.

Choose the right plants

It is a known fact that deer carry ticks. Therefore, try and select plants or shrubs that are not attractive to them. Check with your local nursery for suggestions on the right plants.

Check hiding places

Check common hiding places where ticks may be found. They are most often found on fences, brick walls and patio retaining walls.

Call professionals

Call professionals to help with your tick problem. They generally use barrier sprays or “tick tubes” to stop the growth of tick nymph to full adult ticks in and around your house.

How to Remove an Attached Tick

Use Fine-tipped Tweezers

Always use fine-tipped tweezers and grasp the tick as close to the skin as possible. Do not jerk or twist in a sudden motion. Applying just the right amount of pressure, lift the tick slowly from the skin.

Make sure that the Mouth of the Tick has been Removed

If while removing with tweezers, the mouth of the tick remains in the skin, try again with the tweezers to remove it. If the mouth remains in the skin, it might get infected by other microorganisms and further infection may result.

Do not Crush a Tick with your Fingers

Crushing a tick with your fingers means pushing the mouth of the tick deeper into your skin. If you have accidentally done this, use rubbing alcohol and wipe clean with a tissue.

Dispose off a Live Tick Suitably

You can dispose off a live tick by dropping it in alcohol, placing it in a sealed bag/container, or by flushing it down the toilet.

Final Words

In the years before the 1960s, when effective antibiotics were not available, nearly 25% of the people affected by RMSF died. But with recent medical developments and awareness, the figure has come down to only 5% today. Be wary of ticks, and if you think you have been bitten rush to a disease. It need not just be RMSF. In case you have been diagnosed with RMSF in its early stages, rest assured. Doxycycline is very effective in the treatment of RMSF in such a case and is known to have very few side effects.

  1. https://www.mayoclinic.org/diseases-conditions/drug-allergy/expert-answers/sulfa-allergy/faq-20057970

 

Dos and Don'ts

Dos
  • Inform the doctor if you are allergic to any drugs suggested for treatment.
  • Consult a doctor as soon as you get headaches or nausea and have a high fever and know you have been bitten by a tick.
  • Get medical attention even if you have not been bitten but have the above symptoms and have recently been to tick-infested areas.
  • Inform the doctor of any other medical conditions you may have.
Don'ts
  • Wait until the second week of illness to consult a doctor as the chances of mortality will increase.
  • Wait for a rash to appear before you consult a doctor. Substantial proportions of deaths occur in patients without rash.
  • Use any home-based remedies once the disease has taken hold. There are no known natural remedies that work.
  • Take the tick into the laboratory for testing because such tests can be inconclusive.

 

 

 

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Common diseases that could cripple your vital organs Brain, heart, kidney, lungs, and liver - these vital organs are indeed vital for your survival. However, these…
Moringa drink
Moringa: This could be the most nutrient-dense food known to us! Moringa is a lush green tree brimming with over 90 essential nutrients required for a healthy mind and…
EMG electromyography
EMG- Electromyography EMG detects the presence, location, and extent of diseases that damage the nerves such motor neuron disease. Electromyography…
Squid-ink-spaghetti
Squid Ink: A unique food coloring and flavoring agent Want to add a unique black color to your pasta, noodles and ice-creams? How can you use squid…
Squid-ink-spaghetti
Squid Ink: A unique food coloring and flavoring agent Want to add a unique black color to your pasta, noodles and ice-creams? How can you use squid…
Squid-ink-spaghetti
Squid Ink: A unique food coloring and flavoring agent Want to add a unique black color to your pasta, noodles and ice-creams? How can you use squid…
Cayenne: The remarkable benefits of these red hot chili peppers These may make you rush for a glass of water, but cayenne pepper is actually a healthy additive…
Salt dangers
Sodium chloride: The wonders and dangers of the simple table salt Sodium chloride is a salt containing sodium and chlorine ions at a 1:1 ratio. It is edible and…
Vaginoplasty - Post-op care
Vaginoplasty Know more about vaginoplasty, the procedure, post-operative care, best options for treatment, cost, and possible risks. %%sitename%% %
ureteroscopy
Ureteroscopy Ureteroscopy is the diagnostic procedure which is used for the detection of the kidney stones in addition to…
Okra: How can this nutrient-dense vegetable help you fight diabetes? Okra is a food which is rich in nutrients and minerals which are extremely essential for a healthy…
Juice Plus: Can you really replace actual fruits with pills?  Juice Plus supplements intend to fill nutritional gaps present in our daily diet. But how successful have they…
Diabetes blood test
Diabetic Profile The diabetic profile is a set of tests used for testing and monitoring the various kinds of Diabetes…
Bronchoscopy procedure
Bronchoscopy Bronchoscopy is a procedure where in a scope is inserted into the lung pathway to observe any growth…
Cordyceps: How the Caterpillar fungus works as a proven cancer-shield Strange as it may sound, but cordyceps or "caterpillar fungus", a fungus variety native to the Himalayas may…
apolipoprotein a1 test
Apolipoprotein -A1 (APO-A1) Test Apolipoprotein A-I (Apo-A1) constitutes 70% of protein content in high-density lipoprotein (HDL) and helps in lipid metabolism.
Pelvic_ultrasound
Pelvic Ultrasound Pelvic ultrasound is a process where sound waves are used to create image of your pelvic region organs…
Tart Cherry: The healthiest excuse for taking that second serving of pie Tart cherry has been traditionally used in delectable desserts such as pies. Recent studies have revealed that its…
General adaptation syndrome: Understanding stress, one step at a time The struggle of the body to produce hormones during a stressful situation is the main theme of general…
Astaxanthin: Why experts believe it could be 550x more potent than vitamin E! What is astaxanthin and why is this new supplement on the block touted as the most powerful antioxidant…
stevia side effects
Stevia: A healthy sugar substitute or yet another risky additive? Stevia is a plant native to South America.  It has been used as a natural sugar substitute and…
Milk Thistle skin
Milk Thistle: Find possible cures for fatal diseases in these purple blooms Milk thistle is well-known for treating liver conditions. However, did you know that it comes with a plethora…
smelling-salts-benefits
The actual science behind smelling salts and how it helps in injury recovery Most smelling salts are a mixture of ammonium carbonate and some perfumes which are sniffed by an individual…
hsv igg test
Herpes Simplex Virus I (HSV)-IgG Test Herpes Simplex Virus I (HSV)-IgG is used to detect the presence of the herpes virus so that the…
Quinine: How gin and tonic came to be known as a potent health elixir The discovery of quinine-containing tree bark is sometimes considered the most serendipitous medical discovery of the 17th century.
anti ds dna test
Anti Ds-DNA antibody Test The  Anti Ds-DNA antibody test is used to diagnose the disease called lupus or more aptly the SLE(Systematic…
piles
Best treatment for piles in Bangalore All you need to know about piles and piles treatment in Bangalore - the types of treatment available,…
cystatin C
Cystatin C Test Cystatin C is a specific single-chain protein that is found in body fluids and is a biomarker for…
Echocardiogram
Echocardiography – ECHO Echocardiography (commonly known as ECHO) is an imaging modality (similar to ultrasonography) used to visualize the interior of…
hidden benefits walking
9 benefits of walking we bet you didn’t know! Did you know walking can be the miracle pill for eternal youth? Everyone knows walking is good for…
biopsy procedure
Biopsy Biopsy is a procedure of studying a live tissue sample collected from a specific organ for diagnosing a…
gallbladder diet tomato
Gallbladder surgery :Tips on post-operative care and diet What to eat post a gallbladder surgery? What are the key things to avoid if you had a…
Did you know drinking alkaline water could be the healthier choice for you? Ever wondered how safe is your drinking water in terms of pH? Recent studies have revealed that Alkaline…
angiography
Angiography Angiography is a diagnostic tool used to determine the narrowing or blockage in the arteries and veins supplying…
ketoacidosis diabetes
HB1Ac Test HB1Ac test is an important blood test that is used to measure the levels of glycated hemoglobin in…
Gua sha: Scraping away layers of pain with this ancient healing tool Gua sha is an ancient oriental healing method which focuses on scraping the body with specific tools to…
Dragon Fruit – Blessing from Nature’s Basket Dragon fruit is packed with nutrients but low on calories. It is the dream food that can help…
alcohol toxic
7 startling facts that will make you quit alcohol today Does drinking really make you friendly and happy? How many calories does a can of cold beer add…
eating disorder anorexia
Eating Disorders: Lifestyle choice or a psychological condition? Is eating disorder just a harmless bad habit? Or does it represent grim psychological disorders? Do you want…
Hepatitis A virus infected liver
Hepatitis A Virus (HAV) Total Blood test to look for IgM antibodies to know if you are infected with Hepatitis A virus (HAV),…
Goji berry: A traditional Chinese berry that packs the best of antioxidants Goji berry is an ancient berry that is considered to be power-packed with nutrients and antioxidants. Which means…
social media adddiction
Your health in the age of Social Media: Why is digital detox a necessity? Did you know that more than 400 million people are dangerously addicted to social media? Are you one…
labiaplasty
Labiaplasty Labiaplasty is a surgical procedure to modify the labia minora and the labia majora. Learn about who can…
amylase test
Amylase Test Amylase test is done by checking the level of this protein in the blood sample and also in…
woman with abdominal pain holding ovulation calendar
Ovulation – facts to know about ovulation Learn how and when ovulation occurs, demystify common misconceptions, identify symptoms, methods of detection and right period for…
6 arguments in favour of glucosamine and where can you find it Studies have shown that glucosamine works by preventing the breakdown of cartilage of the joints. This is usually…
shakeology woman
Meal replacement or protein drink? Learn all about Shakeology and its claims Shakeology from Beachbody claims to be the most suitable shake that can aid in weight loss, regulate blood…
anoscopy
Anoscopy Anoscopy is an invasive diagnostic procedure where a small device known as anoscope will be inserted in the…
Pescatarian Diet 101: What are the inherent health advantages of this diet? People opt to become a pescatarian in order to enrich their bodies with the essential health benefits that…
Low fat diets
A complete list of low-fat diets and how to follow them Low-fat diets help you lose weight in a healthy way, but it works only with regular exercise and…
kefir bottle
Kefir: Top reasons why this probiotic drink should be consumed by you Yet another remarkable fermented food, kefir is a much healthier version of yogurt. These chewy white grains can…
Oil of Oregano: The one-stop essential oil you’ve been looking for Are you plagued by a weak immune system? High body inflammation accompanied by pain and infections? Why not…
Ear pain model
Easy and safe tips for ear wax removal you can do at home Cerumen impaction generally occurs when an external object like cotton swabs are used to remove the ear wax.…
Infertility man
Infertility profile (men) The group of tests that for a part of the infertility profile testing for men includes a range…
Period sanitary napkin-menstruaion-blood-colors
Period blood – what it says about your health Your period blood color and consistency indicate what is happening in your body. Is your blood bright red…
CERULOPLASMIN- triple marker
Triple Marker Test A triple marker test is an important prenatal test that is performed to detect the presence of chromosomal…
Bloodtestalbumin
Albumin Test Albumin test or blood serum test is a liver function test that measures the amount of the protein…
Hibiscus: Nourish your beauty and health with these vibrant blooms Hibiscus is a trumpet shaped flower found abundantly in tropical countries. It has been historically used for its…
Coffee Enema: Turn your favorite morning beverage into a powerful colon cleanser The wonders of coffee are not just limited to waking you up every morning. You can now use…
Top reasons why you need to pay attention to your vitamin B6 intake Vitamin B6- An essential water-soluble vitamin. Its deficiency leads to physical changes such as sores & glossy tongue…
C-Reactive Protein Test A CRP or c-reactive protein blood test is an important diagnostic tool used to determine the risk of…
chloride test
Chloride Test A chloride test of the blood checks the level of chloride in body, an important factor governing the…
sodium chloride
Halotherapy: How inhaling salt can work wonders for your body Halotherapy is quickly gaining popularity amongst those with respiratory diseases. It has shown promise in its treatment.
myelogram
Myelography Myelography is an important diagnostic tool that is used to investigate and identify abnormalities in the spine and…
Experts reveal the safest ways to perform an enema at home The idea of pushing some up your rectal area might make you queasy but an enema could actually…
complement c4 test
Complement 4 (C4) Test The Complement 4 or C4 test measures the level of the protein in the bloodstream, and is primarily…
Vagus nerve: 7 health benefits of stimulating the “gut-brain” connection As a matter of fact, there are two vagus nerves namely the left and the right but is…
cystoscopy
Cystoscopy Cystoscopy is a procedure to check the health of the urethra and the bladder. The procedure is also…
Barium-enema
Barium Enema Barium enema is also known as colon x-ray. Here, the patient is asked to consume small amount of…
Psyllium Husk: More than just an effective natural laxative Psyllium husk, or isabgol, is a popular natural laxative . But did you in addition to regulating bowels,…
Miracle extract from the root of maca: 10 ways it can help you! Maca root has been used for years in herbal medicine. Today scientific research is unearthing fresh evidence in…
PROGESTERONE_test
Progesterone test The progesterone test is a blood test used to determine the level of hormone progesterone in the blood…
Spinach: The ultimate way to boost health with this green superfood! Spinach is a green superfood that ranks high in both taste and nutrition. Read more to discover how…
DHEA wrinkles
DHEA: Now get unbelievable age defiance with this wonder hormone! DHEA is known popularly as the age-defying hormone. This supplement is widely used to slow down aging and…
Ca 19.9 test
CA19.9 Test CA 19.9 is a cancer antigen that exists on the surface of cancer-causing cells. The levels of CA…
kshar sutra
Kshar sutra treatment for piles, fissures and fistula Read to know the benefits and side effects of kshar sutra to treat anal piles, fissures, and fistula…
deep vein thrombosis
Deep vein thrombosis Deep vein thrombosis or DVT occurs when blood clots form in the deep veins of the body, mainly…
Keto diet healthy
Keto Diet: Did you know you could eat fats to burn fats? Keto diet - A wonder diet that lets you eat fats and lose weight too! Read on to…
Thyroid disorders
Thyroid Profile Thyroid profile is a panel of blood tests performed to check if an individual is suffering from any…
valproic acid test
Valproic Acid Test Valproic acid test is performed to generally check for psychiatric and even neurological conditions such as bipolar disease…
creatinine
Creatinine Test The level of creatinine in the blood is a significant indicator of the health of your kidneys. This…

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