Rocky Mountain Spotted Fever

Rocky Mountain Spotted Fever is a tick-borne infection. 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 many other states. Most cases, over 60%, occur in North Carolina, Tennessee, Oklahoma, Arkansas, and Missouri. The infection is also 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. Sepsis, which was often called blood poisoning, is the body’s life-threatening 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 spreads

You cannot catch RMSF from another person. It can only be transmitted by a tick 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.

You can find ticks 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.

Rocky Mountain Spotted Fever symptoms

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, doctors make a diagnosis of RMSF based on your history and your signs and symptoms. Early RMSF treatment is important. Treatment often starts before your test results return.

Treatment for RMSF should begin as soon as possible to avoid complications. The usual medication used to treat RMSF is the antibiotic doxycycline. You may need a different antibiotic however, depending on your individual situation. It is important you complete your full course of antibiotics as prescribed.

Rocky Mountain Spotted Fever complications

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.

Examine 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 methods 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 is off, 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. If you find a tick bite, 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. Rocky Mountain Spotted Fever caused her sepsis. 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.” 

Suggested Citation: Sepsis Alliance. Sepsis and Rocky Mountain Spotted Fever. 2023. https://www.sepsis.org/sepsisand/rocky-mountain-spotted-fever/

Updated June 7, 2023.

Read Personal Stories of Sepsis and Rocky Mountain Spotted Fever

Gabriella (Gabby) Galbo

Tribute

May 1, 2012 was the start of a week which would forever change our lives. Gabby was a vivacious, funny, and smart five-year-old girl who loved cupcakes, animals, and spending time with her family. She had the sense of humor of an adult, and was the most kind, caring, and loving child. Gabby was so happy to love and to be loved. She adored her pet Chihuahua Bella, and enjoyed hanging out with her sisters, Nina who was seven at the time, and Sophia whom was thirteen at the time. Her smile was contagious and could light up a room. ... Read Full Story

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Rocky Mountain Spotted Fever

Rocky Mountain Spotted Fever is a tick-borne infection. 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 many other states. Most cases, over 60%, occur in North Carolina, Tennessee, Oklahoma, Arkansas, and Missouri. The infection is also 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.