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Rocky Mountain Spotted Fever

Definition :
Rocky Mountain spotted fever is a potentially serious bacterial infection transmitted to humans by tick bites. The illness is named after the Rocky Mountain region where the disease was first identified. Rocky Mountain spotted fever occurs when an infected tick attaches to your skin and feeds on your blood. The infection then has the potential to spread to your bloodstream and other areas of your body.

Rocky Mountain spotted fever isn't contagious and doesn't spread directly from person to person. If treated promptly, a case of Rocky Mountain spotted fever is usually fairly mild. In a small percentage of people, the disease can be serious, even fatal, especially in older adults. Rocky Mountain spotted fever can progress rapidly to a widespread infection throughout your body, and prompt treatment is important.

Causes:
The cause of Rocky Mountain spotted fever is the organism Rickettsia rickettsii. This bacterium most often is spread to humans by tick bites. Ticks can attach themselves to your skin and feed on your blood. They can lodge anywhere on your body, but often are found in your hair, around your ankles and in your genital area. Once embedded in your skin, ticks can cause a small, hard, itchy lump surrounded by a red ring or halo. The longer an infected tick stays attached to your skin, the greater your chance of acquiring infection.

Rocky Mountain spotted fever also can be transmitted through broken skin, such as a cut or scrape on your hands or fingers. Bacteria that cause this disease circulate in the fluids of a tick's body. If you squeeze or crush a tick as you remove it from yourself, another person or a pet, an infection can occur if the fluid comes in contact with an area of broken skin.

The culprit ticks
The bacterium that causes Rocky Mountain spotted fever typically is carried by a genus of ticks known as ixodes or hard ticks. These ticks live in the low bushes and tall grasses of wooded areas and are more abundant in late spring and early summer.

In the western United States, Rocky Mountain spotted fever is transmitted by the wood tick (Dermacentor andersoni). In the eastern United States, where the disease is most common, it's transmitted by the dog tick (Dermacentor variabilis). In the southern United States and Central and South America, the disease is transmitted by other ticks, such as the lone star tick (Amblyomma americanum). Rocky Mountain spotted fever primarily occurs when ticks are most active and during warm weather when people tend to spend more time outdoors.

Risk Factor :
Your risk of contracting Rocky Mountain spotted fever depends on what part of the United States you're in, how much time you spend in grassy or wooded areas, and how well you protect yourself. It's important to take precautions against exposure to ticks and to be sure to check yourself for ticks after being outside.

When to seek medical advice :
See your doctor if you develop a rash or become sick after a tick bite. Rocky Mountain spotted fever and other infectious diseases carried by ticks, such as Lyme disease, can progress rapidly and may be life-threatening. If possible, take the tick along with you to your doctor's office for laboratory testing.

Symptoms:
The signs and symptoms of Rocky Mountain spotted fever include :

  • High fever — body temperature of 101 F (38.3 C) or greater
  • Chills
  • Severe headache
  • Widespread aches and pains
  • Restlessness
  • Nausea and vomiting
  • Loss of appetite
  • Sore throat
  • Fatigue
  • A rash of red spots or blotches

Three to 10 days after being bitten by an infected tick, you may develop nausea, headache, loss of appetite and a sore throat. As Rocky Mountain spotted fever develops, fever, chills, tenderness and soreness in your bones and muscles, restlessness, trouble sleeping (insomnia), abdominal pain and vomiting may occur. You may have a cough and, possibly, delirium, lethargy and stupor.

Between the second and sixth day of the fever, a red rash may appear on your wrists, ankles, palms of your hands and soles of your feet. The rash often spreads up your arms and legs to your torso.

Diagnosis:
Your doctor will likely be able to diagnose Rocky Mountain spotted fever by evaluating your signs and symptoms and by conducting a physical examination. In addition, he or she may order a blood test or examine a specimen of the rash or the tick itself to search for the presence of the organism that causes this infection.

Complications :
If detected in its early stages, Rocky Mountain spotted fever can be treated with medication. If left untreated, the infection can spread from the site of the bite via your bloodstream, potentially causing infection in other areas of your body. Rocky Mountain spotted fever may cause serious complications involving your joints, heart, lungs, kidneys, and central and peripheral nervous system, such as :

  • Heart, lung or kidney failure
  • An infection of the membranes and fluid surrounding your brain and spinal cord (meningitis)
  • Brain damage
  • Problems with blood clotting
  • Shock

Treatment:
Treatment for Rocky Mountain spotted fever involves careful removal of the tick from your skin and antibiotic medication, such as doxycycline or tetracycline, to eliminate the infection. Prompt treatment of Rocky Mountain spotted fever is important because the disease can progress rapidly and may cause serious illness.

How to safely remove a tick
If you find a tick crawling on your skin, carefully remove it. Don't crush it between your fingers. Instead, burn it, bury it or flush it. Be sure to wash your hands afterward.

If a tick has already bitten you and is holding on to your skin, follow these steps :

  • Remove the tick by gently grasping it near its head or mouth, preferably with a tweezers.
  • Don't squeeze or crush the tick, but pull carefully and steadily.
  • Save the tick by sealing it in a plastic bag and storing it in the freezer. This allows the tick to be tested for specific bacterium by your doctor if you become sick from the bite. If no signs or symptoms of infection occur within two weeks after the bite, dispose of the tick by burning it, burying it or flushing it.
  • Disinfect the tweezers with alcohol or antibacterial soap and water.
  • Wash that area of your skin thoroughly and apply antiseptic to the bite area after the tick has been removed.
  • Wash your hands thoroughly.

Prevention:
You can decrease your chances of contracting Rocky Mountain spotted fever by taking some simple precautions :

  • Wear long pants and sleeves. When walking in wooded or grassy areas, wear shoes, long pants tucked into socks and long-sleeved shirts. Try to stick to trails and avoid walking through low bushes and long grass.
  • Use insect repellents. Products containing DEET (Off! Deep Woods, Repel) or permethrin (Repel Permanone) often repel ticks. Be sure to follow the instructions on the label. Clothing that has permethrin impregnated into the fabric also may be helpful in decreasing tick contact when outdoors.
  • Do your best to tick-proof your yard. Clear brush and leaves where ticks live. Keep woodpiles in sunny areas.
  • Check yourself and your pets for ticks. Do this after being in wooded or grassy areas. Some ticks can sometimes be no bigger than the head of a pin, so you may not discover them unless you are very careful. Showering immediately after leaving these areas is a good idea because ticks often remain on your skin for hours before biting.
  • Don't assume you're immune. Even if you've had Rocky Mountain spotted fever before, it can occur in the same person more than once. Follow precautions and check yourself for ticks.
  • Remove a tick with tweezers. Gently grasp the tick near its head or mouth. Don't squeeze or crush the tick, but pull carefully and steadily. Once you have the entire tick removed, apply antiseptic to the bite area.
 
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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