Rocky Mountain Spotted Fever

What is Rocky Mountain spotted fever?

Rocky Mountain spotted fever (RMSF) is an infection caused by the bite of a tick infected with bacteria. Sometimes it causes a very severe illness and can be fatal. Prompt treatment is important.

What is the cause?

Ticks are found in woodlands, grasslands, and marshlands and at the seashore. Wild birds and animals, as well as domestic animals and pets such as dogs, horses, and cows, can carry ticks. Ticks may climb on humans from animals, leaves, or low-lying brush. Ticks cannot jump or fly.

This disease does not spread from person to person. It is spread from the bite of an infected tick, or by contact with a crushed tick or tick feces. In the US the infection is more common during the months of April through September. The ticks that cause RMSF are mostly found east of the Rocky Mountains and along the west coast.

What are the symptoms?

The first symptoms may include:

  • Fever
  • Nausea and vomiting
  • Severe headache
  • Muscle pain
  • Lack of appetite

A few days later you may start having a pink or red and spotted rash. The rash may start on the palms of your hands and soles of your feet. You may also have the rash on your wrists, forearms, ankles, and your trunk. You may also have:

  • Stomach pain
  • Joint pain
  • Diarrhea

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. Tests may include:

  • Blood tests
  • A skin biopsy, which is the removal of a small sample of tissue for testing

Because the symptoms of RMSF are similar to many other conditions, it can be difficult to diagnose.

How is it treated?

You will probably stay at a hospital for treatment. You will be given antibiotics, and you may be given fluids and pain medicines by IV.

If you are treated with antibiotics within the first few days of the infection, the fever and other symptoms usually start to get better after 2 or 3 days of treatment. If you have severe symptoms or you did not get treatment right away, it may take longer to recover. Without prompt treatment the disease can be fatal.

How can I take care of myself?

Follow the full course of treatment prescribed by your healthcare provider. You need to take all of your antibiotic medicine. Do not stop taking antibiotics because you start to feel better or your symptoms go away. Ask your healthcare provider:

  • How long it will take to recover
  • If there are activities you should avoid and when you can return to your normal activities
  • How to take care of yourself at home
  • What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup.

How can I help prevent Rocky Mountain spotted fever?

  • In areas of thick underbrush, try to stay near the center of trails.
  • When you are outdoors, wear long-sleeved shirts tucked into your pants. Wear your pants tucked into your socks or boot tops if possible. A hat may help, too. Wearing light-colored clothing may make it easier to spot a small tick before it reaches your skin and bites. While you are outside, check for ticks every 4 hours and remove any ticks on clothing or exposed skin.
  • Use approved tick repellents on exposed skin and clothing. Don’t use more repellent than recommended in the package directions. Don’t put repellent on open wounds or rashes. When using sprays, don’t spray the repellent directly on your face. Spray the repellent on your hands first and then put it on your face, but not close to your eyes or mouth. Then wash the spray off your hands.
    • Adults should use products with no more than 35% DEET. Children older than 2 months can use repellents with no more than 30% DEET. DEET should be applied just once a day. Wash it off your body when you go back indoors. Some products contain more than 35% DEET. The higher concentrations are no more effective than the lower concentrations, but they may last longer. Read the label carefully before applying.
    • Picaridin may irritate the skin less than DEET and appears to be just as effective.
    • Spray clothes with repellents because insects may crawl from clothing to the skin or bite through thin clothing. Products containing permethrin are recommended for use on clothing, shoes, bed nets, and camping gear. Permethrin-treated clothing repels and kills ticks, mosquitoes, and other insects and can keep working after laundering. Permethrin should be reapplied to clothing according to the instructions on the product label. You can buy clothing and hats pretreated with permethrin. Permethrin does not work as a repellent when it is put on the skin.
  • Treat household pets for ticks and fleas. Check pets after they’ve been outdoors.
  • Brush off clothing and pets before entering the house.
  • After you have been outdoors, undress and check your body for ticks. They usually crawl around for several hours before biting. Check your clothes, too. Wash them immediately to remove any ticks.
  • If you find a tick attached to your body, you need to remove it.
    • Grasp the tick with tweezers or fingers (covered with gloves or a tissue) as close to the skin as possible. Gently pull the tick straight away from you until it releases its hold. Use a slow gentle pulling motion. Pulling the tick out too quickly may tear the body from the mouth, leaving the mouth still in the skin. If you are unable to remove the tick completely, you may need to see your healthcare provider. Do not twist the tick as you pull, and try not to squeeze its body.
    • After you have removed the tick, thoroughly wash your hands and the bite area with soap and water. Put an antiseptic such as rubbing alcohol on the area where you were bitten.
    • Put the tick in a sealed plastic bag and keep it in the freezer. Identification of the tick may help your provider diagnose and treat any symptoms. If you do not have any symptoms of disease after 1 month, you can throw away the tick.
  • Shower and shampoo after your outing.
  • Inspect any gear you were carrying.
  • If you spend much time hiking, you may want to include a pair of tick tweezers in your first-aid kit. You can buy them at sporting goods stores.

You can get more information from:

Developed by RelayHealth.
Adult Advisor 2015.1 published by RelayHealth.
Last modified: 2014-05-27
Last reviewed: 2014-07-10
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Copyright ©1986-2015 McKesson Corporation and/or one of its subsidiaries. All rights reserved.

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