ROCKY MOUNTAIN SPOTTED FEVER

General Information

DEFINITION--An acute illness with fever caused by an organism transmitted by infected ticks. This is not contagious from person to person. The disease was named for the geographic site of its original discovery.

BODY PARTS INVOLVED--Skin; central nervous system; gastrointestinal tract; muscles.

SEX OR AGE MOST AFFECTED--Both sexes; all ages, more likely to occur in children and young adults.

SIGNS & SYMPTOMS--

The following occur 2 to 5 days after a tick bite:

• Fever, often high, with chills.
• Red skin rash that begins on hands and feet and spreads to ankles, wrists, legs, trunk and abdomen.
• Headache.
• Muscle aches and weakness; stiff back.
• Nausea and vomiting.
• Mental confusion; coma.

CAUSES--Rickettsia organisms that live inside ticks. People are infected through tick bites, usually in the spring or summer. Rickettsia also infect rodents, squirrels and chipmunks. The disease occurs in about 40 states of the U.S., especially on the Eastern seaboard from Georgia to Maryland, and in heavy brushy areas, such as Long Island. The tick is found in urban areas as well as rural. The disease can be transmitted by transfusion of contaminated blood.

RISK INCREASES WITH

• Outdoor activities in tick-infested areas.
• Contact with dogs.

HOW TO PREVENT

• Wear protective clothing in tick-infested areas and use insect repellant.
• During outdoor activity, carefully inspect the body frequently to remove ticks. Don't crush them during removal as the whole tick must be removed. Hold a lighted cigarette near the tick, or apply gasoline, kerosene or oil to the tick's body. Pull it off with tweezers.
• No vaccine is currently available, but research continues.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory studies, such as blood counts, serological tests (See Glossary) and skin biopsy (See Glossary). The history of a tick bite or travel to a tick-infested area helps confirm diagnosis.

APPROPRIATE HEALTH CARE

• Doctor's treatment. This may be a medical emergency.
• Patients with mild disease may be treated at home; but more likely, the infection will require hospitalization (may need mechanical breathing support, blood transfusions and close watch for complications such as kidney failure).

POSSIBLE COMPLICATIONS

• Brain infection.
• Seizures.
• Kidney failure.
• Hepatitis.
• Rocky Mountain spotted fever is often fatal if untreated (due to pneumonia or heart failure).

PROBABLE OUTCOME--Curable if antibiotic treatment is begun in the early stages.

How To Treat

GENERAL MEASURES----If the patient is hospitalized, the family should maintain an optimistic outlook, stay in close contact with the patient's doctor and help by making their visits with the patient brief and as supportive as possible.

MEDICATION--Your doctor may prescribe antibiotics, such as tetracycline, doxycycline or chloramphenicol.

ACTIVITY--Rest in bed until fever and other symptoms disappear.

DIET--No special diet. Critically ill patients may require intravenous feedings. In others, small frequent meals may be necessary.

Call Your Doctor If

• You have symptoms of Rocky Mountain spotted fever.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.