Rocky Mountain Spotted Fever - Causes, Symptoms, Diagnosis, and Treatment

Introduction:

Rocky Mountain spotted fever refers to a bacterial illness that has been nationally notifiable since the 1920s. Since January 1, 2010, the cases of Rocky Mountain spotted fever have been reported under a new category; spotted fever rickettsiosis (SFR). It includes Rocky Mountain spotted fever, rickettsialpox, Rickettsia parkeri rickettsiosis, and pacific coast tick fever.

This was because of the inability to differentiate between the conditions using the available serologic tests. The SFR cases have risen in the last two decades from 495 cases in 2000 to 6248 cases in 2017. However, they have reduced slightly per the case reported in 2018 and 2019. However, the number of Rocky Mountain spotted fever cases is unclear. The SFR cases can occur any time of the year, but most cases are reported between May and August.

What Is Rocky Mountain Spotted Fever?

Rocky Mountain spotted fever is a bacterial disease transmitted through an infected tick bite. It is considered one of the most serious tick-borne illnesses in the United States. The illness is characterized by a sudden high fever of around 102 ^oF to 103 ^oF, distinctive rashes, vomiting, headache, muscle aches, and abdominal pain. It may also result in serious damage to the internal organs or even lead to death if not treated.

What Causes Rocky Mountain Spotted Fever?

The Rocky Mountain spotted fever is caused by the bacteria, Rickettsia rickettsii. It is primarily spread to humans through infected tick bites. The bacteria multiply once inside the body and spread throughout the bloodstream and the lymphatic system. One might not even realize the tick bite, and the infected bite can attach itself to the skin, feed on blood for six to ten hours, and spread the infection. The more the tick stays attached to the person's body, the more likely the illness. The disease's incubation period may range from 3 to 12 days, depending on the volume of the inoculum.

How Is Rocky Mountain Spotted Fever Spread?

The Rocky Mountain spotted fever is spread through infected ticks, primarily through American dog ticks, brown dog ticks, and Rocky Mountain wood ticks. These ticks are most active in the summer and spring when people spend more time outdoors. These are common in wooded and grassy areas; a pet could get ticks on its body if it roams outside. One could get the ticks roaming in the woods or even from a pet. However, the illness does not spread from person to person.

What Are the Risk Factors of Rocky Mountain Spotted Fever?

The factors that can increase the risk of getting Rocky Mountain spotted fever include:

• Staying in areas where the disease is common.

• The summer and spring months are when the ticks are most active.

• Spending much time in grassy or wooded areas.

• Spending time with a tick-infested pet.

What Are the Symptoms of Rocky Mountain Spotted Fever?

The illness's symptoms usually appear two to 14 days after the infected bite.

The symptoms usually include:

• Sudden high fever that may persist for two to three weeks.

• Chills.

• Muscle pain.

• Headache.

• Nausea and vomiting.

• Fatigue.

• Loss of appetite.

• Abdominal pain.

• Diarrhea.

• Hallucinations.

• Thirst.

• Light sensitivity.

The most distinctive sign of Rocky Mountain spotted fever is a small red rash on the feet' wrists, ankles, palms, and soles. It may begin two to five days after the fever and then gradually spread inwards towards the torso. After the sixth day, a purple-red rash can develop; this is a sign that the infection has progressed and become more serious. Hence, treatment must be taken before this rash.

How Is Rocky Mountain Spotted Fever Diagnosed?

The diagnosis of Rocky Mountain spotted fever could be difficult as the symptoms are similar to other illnesses, such as flu. The most distinctive symptom to look out for is the rash. Other tests include:

• Antibody titer by complement fixation or immunofluorescence.

• CBC (complete blood count).

• Kidney function test.

• Prothrombin time.

• Partial thromboplastin time.

• Urine analysis.

• Skin biopsy of the rash sample.

How Is Rocky Mountain Spotted Fever Treated?

Rocky Mountain spotted fever is treated with oral antibiotics. Doxycycline is the preferred drug for both adults and children. Chloramphenicol is recommended for pregnant women. The Centers for Disease Control and Prevention (CDC) recommends that one must take antibiotics as soon as the disease is suspected, even before receiving laboratory reports. The delay in treatment could lead to significant complications. Hence, begin the treatment as soon as possible, preferably within the first five days of the infection. If the disease progresses, one might need hospitalization for a longer period to be monitored.

What Are the Complications of Rocky Mountain Spotted Fever?

If the illness is not treated properly within the initial phase, rocky mountain spotted fever could harm the lining of the organs and blood vessels.

Other complications may include:

• Inflammation of the heart.

• Encephalitis.

• Inflammation of the lungs.

• Kidney failure.

• Liver and spleen enlargement.

• Meningitis.

• Gangrene in the fingers and toes.

• Death.

Other long-term health conditions that could be associated with Rocky Mountain spotted fever include:

• Hearing loss.

• Muscle weakness.

• Partial paralysis of the body.

• Neurological deficits.

How to Prevent Rocky Mountain Spotted Fever?

To prevent Rocky Mountain spotted fever, one must prevent ticks.

To prevent ticks:

• Stay away from densely wooded areas.

• Keep the lawn clean - Mow the lawn, rake leaves, and trim trees in the yard.

• When going to a grassy or wooded area, tuck the pants into the socks and shirt into the pants to avoid space for ticks.

• Wear protective boots.

• Wear light-colored clothing to spot ticks easily.

• Use insect repellent containing DEET (N, N-diethyl-meta-toluamide) and permethrin on clothing.

• Check the clothing for ticks every three hours.

• Check the body thoroughly for ticks after coming from outside.

• Take a shower and scrub the body after coming from outside.

• Check the pet for ticks regularly.

• Get safe products advised by a veterinarian for tick control in pets.

If one finds a tick attached to the skin, do not panic. Removing the tick properly is essential to reduce the likelihood of the disease.

• Use a tweezer to hold the tick as close to the skin as possible.

• Do not jerk or squeeze the tick.

• Pull the tweezer away from the skin slowly upward until the tick detaches.

• After removing the tick, clean the bite area with soap and water. Disinfect the tweezers with rubbing alcohol.

• Place the tick carefully in a sealed container and take it to the doctor for testing and identification.

Conclusion:

Rocky Mountain spotted fever is a bacterial disease transmitted through infected tick bites. They are serious illnesses that need immediate medical attention. If one suspects a tick bite, consult the doctor immediately. With early treatment, the condition is curable.