RMSF or Rocky Mountain Spotted Fever is a bacterial disease (Rickettsia richettsii - named for Dr. Howard T. Ricketts who discovered it early in the 20th century) spread through the bite of the American Dog tick (Dermacentor variabilis), the wood tick (Dermacentor andersoni) or most commonly in the east the Lone Star tick (Amblyomma americanum).  The highest incidence of Rocky Mountain Spotted Fever is actually east of the Mississippi River with most cases reported in North and South Carolina.

Missouri and Arkansas also have high rates of infection.  The peak season is April through September which corresponds to the highest activity among ticks and numbers of people outdoors.

Within 2-8 days a person transmitted (states with highest incidence have 16-17 cases per million population) the disease through a tick bite will have the following symptoms:

Headache, fever >101, rash (red blotchy in 1st 5 days, non-blanching after day 6) and a severe flu-like illness in 80-90% of infected people.

Less commonly, confusion, nausea, vomiting, abdominal pain, inflammation of the conjunctiva, sensitivity to light, enlarged liver and enlarged spleen may occur.

Several laboratory values will be abnormal including low platelets, low serum sodium, and elevated BUN (Kidney) and liver function tests (ALT).

The treatment is with an antibiotic, doxycycline.  RMSF has the highest incidence of mortality of all tick-borne illnesses in North America, especially in young children and those over 50 years old.

Prevention of tick bites through use of surveillance, repellents like DEET applied to the skin and permethrin (an insecticide) applied to your clothing is the best way to not acquire RMSF.  It takes much less time (hours) to transmit RMSF than it does Lyme Disease (1-2 days).

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