Understanding Rocky Mountain Spotted Fever

people hiking in the woods

Summer is finally in sight! While this means more sunshine, enjoyable weather and outdoor activities, it can also mean bug bites and rashes.

Ticks, like many other insects, peak in population as seasons change. They carry diseases that are dangerous to humans like Rocky Mountain spotted fever, and, more commonly, Lyme disease.

Rocky Mountain spotted fever is an infectious disease transmitted by the bite of a tick infected with rickettsia group bacteria. It is a very rare and potentially fatal disease that causes fever, headache, muscle ache and often a rash. The rash can vary throughout stages of infection and appear as red blotches or small dots. The rash does not appear at the start of infection, making Rocky Mountain spotted fever more challenging to diagnose.

Symptoms can be cured with antibiotics, but, if untreated, long-term complications can occur. Hearing loss, paralysis, permanent damage to blood vessels or mental disability are all possible in severe, untreated cases. In some instances, patients develop a red meat or dairy allergy, causing reactions of nausea, vomiting, hives or anaphylaxis.

In the United States, there are fewer than 20,000 cases per year. However, this disease has increased in prevalence within our region. Unlike the name may suggest, this disease is not unique to the Rocky Mountain region of the country.

Lyme Disease Versus Rocky Mountain Spotted Fever

Initial diagnosis of Rocky Mountain spotted fever may be difficult, as Lyme disease is more commonly associated with tick bites. Lyme disease may cause similar, flu-like symptoms, but causes a bulls-eye rash at the site of the tick bite. Lyme disease may also cause bell’s palsy, which is drooping of the face.

Rocky Mountain spotted fever is transmitted via the American dog tick, brown dog tick and the Rocky Mountain wood tick. Lyme disease is transmitted by the black-legged, or “deer” tick that is infected with borrelia burgdorferi and morrelia mayonii. Deer ticks are typically smaller than the ones that transmit Rocky Mountain spotted fever.

Both diseases are diagnosed through laboratory blood tests to identify the presence of infection. Like Rocky Mountain spotted fever, Lyme disease should be treated as soon as possible with antibiotics and can cause lasting symptoms if untreated.

 What Do I Do After a Tick Bite?

 If you’ve been bitten by a tick, there are several steps you should follow to protect your health.

  1. Remove the tick – Wearing gloves, use sanitized tweezers to gently pull the tick out of the skin. Grasp the tick as close to the skin as possible to avoid leaving parts of the head or mouth embedded in the wound. Do not remove the tick using a hot match or petroleum jelly, for this could cause the tick to expel infected fluids back into the bite. Once removed, save the tick in a container of alcohol to show a doctor.
  2. Clean and disinfect – Wash your hands and clean the bite area with an alcohol wipe to prevent infection.
  3. See a health care provider – If the tick is still embedded in your skin or if the head, mouth or other parts cannot be removed, see a health care provider immediately. Otherwise, seek medical assistance if any of the following occur:
    • You can identify the tick as a deer tick. In this case, a provider may prescribe an antibiotic to help prevent Lyme disease.
    • You develop a bodily rash or flu-like symptoms within 30 days of the bite.
    • The bite area develops a lesion within 30 days of the bite. This may look like a bullseye rash, redness, warmth or inflammation.

 It is essential to note that a tick must be attached for 24 hours or more to transfer enough bacteria to the host’s bloodstream to cause illness, but you can never be too cautious when caring for tick bites. 

Preventative Measures

The only way to prevent tick-borne diseases is to prevent tick bites. Before spending time outdoors, there a few things you can do to prevent tick encounters.

First, you should know when and where to expect ticks. Tick populations are highest from March to June and from August to November. They live in grassy, bushy, wooded areas or on animals. While many think ticks primarily live in thick wooded areas, they can live in your own backyard. Avoid densely wooded areas, where ticks may be more concentrated, to lower your risk of getting bitten.

Clothing and outdoor gear can be treated with 0.5% permethrin to protect against ticks and lasts for several washings. You can treat your clothing at home or purchase pre-treated items. Additionally, use a tick repellent when spending time outdoors.

Once you’re indoors, check yourself and your pets thoroughly for ticks. Within two hours of returning inside, take a shower to potentially wash off any unattached ticks. Studies show that this measure can significantly reduce your risk of tick-borne diseases and provides a great opportunity to do a thorough bite examination.

Ticks enjoy hiding in tight spaces. Check the following locations for ticks after being outside:

    • Underarms
    • In and around ears
    • Inside the belly button
    • Back of the knees
    • In your hair and on your hairline
    • Between the legs
    • Around the waist
    • Anywhere you wore a tight seam (think socks, waistband, under tight straps)

If you are concerned about a tick bite, consult your primary care provider or visit one of our Urgent Care Plus locations for more information.

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Article by: Kenneth Gardner, M.D.

Kenneth Gardner, M.D., is a provider at UofL Physicians - Primary Care. He received his medical degree from the University of Louisville School of Medicine. He completed his internal medicine internship and emergency medicine residency at the University of Kentucky.

All posts by Kenneth Gardner, M.D.
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