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Rocky Mountain Spotted Fever

Rocky Mountain Spotted Fever is an infection spread by tick bites. The infection is named after the area where it was first detected, the Rocky Mountains. Rocky Mountain Spotted Fever (RMSF) is still most often found in the U.S. Southeast, but people have been infected in all other states, except Alaska and Hawaii. The infection has also been found in Canada, Mexico, Central America and South America. Rocky Mountain Spotted Fever is a rare illness, affecting between 250 to 2,000 people per year in the U.S., but it can be fatal if not treated.

As with all infections, Rocky Mountain Spotted Fever can trigger sepsis. Sometimes incorrectly called blood poisoning, sepsis is the body’s often deadly response to infection. Like strokes or heart attacks, sepsis is a medical emergency that requires rapid diagnosis and treatment. Sepsis kills and disables millions and requires early suspicion and rapid treatment for survival.

Sepsis and septic shock can result from an infection anywhere in the body, such as pneumonia, influenza, or urinary tract infections. Worldwide, one-third of people who develop sepsis die. Many who do survive are left with life-changing effects, such as post-traumatic stress disorder (PTSD), chronic pain and fatigue, organ dysfunction (organs don’t work properly), and/or amputations.

How Rocky Mountain Spotted Fever is spread

You cannot catch RMSF from another person. It can only be transmitted by a tick that is carrying R. rickettsia. Most commonly these ticks are the American dog tick (Dermacentor variabilis), Rocky Mountain wood tick (Dermacentor andersoni), or brown dog tick (Rhipicephalus sanguineus).

A tick must be attached to your skin and remain there for between four and 10 hours to transmit the infection to you. Unfortunately, you probably won’t know you have been bitten you because it’s unlikely you would feel it, and the tick may fall off after the bite. Or, you may find the tick, but only after it has been there for several hours.

Ticks are found most often in areas such as woods and areas with brush, shrubs and low tree branches. Dogs that run in these areas could bring ticks to you, as well.

Symptoms of Rocky Mountain Spotted Fever

The signs and symptoms of RMSF usually start to appear two to 14 days after infection. They may include:

  • Fever
  • Rash on your wrists, ankles, palms, and soles. It may appear as small, flat, pink, non-itchy spots.
  • Headache
  • Nausea and vomiting
  • Abdominal pain
  • Muscle pain
  • Poor or no appetite
  • Red eyes

Most people with RMSF (up to 90%) develop a rash two to five days after the tick bite, although some people may see the rash appear later. Ten percent of infected people never notice a rash.

Tests and treatment

Most times, a diagnosis of RMSF is made based on your history and your signs and symptoms. Early treatment of RMSF is important, so while your doctor may order blood tests, treatment is often given before your test results are received.

Treatment for RMSF should begin as soon as possible to avoid complications. The usual medication used to treat RMSF is the antibiotic doxycycline. A different antibiotic may be prescribed however, depending on your individual situation. It is important that you complete your course of antibiotics as prescribed, to ensure the infection is gone.

Complications of Rocky Mountain Spotted Fever

Untreated RMSF can cause severe, life-threatening complications, such as:

  • Encephalitis, inflammation of the brain
  • Inflammation of the heart
  • Inflammation of the lungs
  • Kidney failure
  • Sepsis

Preventing Rocky Mountain Spotted Fever

The only way to prevent contracting RMSF is to avoid bites from ticks that carry the infection. Experts recommend that if you must go into grassy or bushy areas, to take these precautions:

  • Wear long pants, socks, closed shoes, and long sleeves.
  • Tuck your pant legs into yours socks.
  • Use insect repellents.
  • Check your pets for ticks before playing with them or allowing them indoors.

Check your body thoroughly for ticks after you have been in an area prone to ticks. Check the folds of your skin, such as behind your knees, in your groin, and in areas like behind your ears, specifically. If you find a tick, it’s important that you remove it properly to avoid further risk of infection.

Removing a tick

Do not try removing a tick using methods like “painting” it with Vaseline or some other product. Do not try to burn it with a match or any of the methods that people claim have been passed down by generations. The only safe way to remove a tick is with this method:

  • Using a pair of narrow, sharp tweezers, grab hold of the tick as close to your skin as possible.
  • Pull directly up – do not twist or turn the tick. If you do this, the mouth part of the tick may stay under your skin. If this does happen, do not try to dig it out. Simply clean and disinfect the area, and watch for signs if infection.
  • Once the tick has been removed, if you wish to bring it to be identified, place it in a sealed container that has some rubbing alcohol in it. The alcohol will kill the tick.
  • Do not crush the tick if you are going to dispose of it. Place it in a sealed container or flush it down the toilet.
  • Wash the bite area with soap and water and disinfect it with rubbing alcohol or iodine.
  • Wash your hands well.

Not all ticks carry infectious bacteria but if you know you’ve been bitten by a tick, watch for signs and symptoms of infection. If you experience any of the symptoms listed above, see a doctor right away.

The 2017 Erin K. Flatley Spirit Award was given to Liz and Tony Galbo, whose daughter died of sepsis. Her sepsis was triggered by Rocky Mountain Spotted Fever. To read their story, click here.

If you suspect sepsis, call 9-1-1 or go to a hospital and tell your medical professional, “I AM CONCERNED ABOUT SEPSIS.” 

Updated June 2, 2021.