Rocky Mountian Spotted Fever

(Choix fever, New world spotted fever, Pink fever, Tick fever)
This is a tick-borne illness and usually affects 600-800 people per year in the United States, mostly in the southeast states (Oklahoma, Tennessee, the Carolinas, Georgia and Virginia).

It is also in Central and South America.

The tick responsible is more active in spring and summer.

Children between 5-9 years are most commonly bitten.

One reason is that they are more likely to brush against tick carrying shrubbery and get bitten.

Rocky Mountain Spotted Fever is related to typhus and caused by a rickettsia (bacteria-like organism) transmitted by ticks (in the eastern U.S it is the deer tick, while in the western U.S it is the wood tick).
The longer a tick is attached the greater the chance of infection.

That is why daily surveillance (especially for children) when traveling in tick borne areas is essential. Tucking pant legs into trousers and insect repellants also help.

Ticks should be carefully removed to not leave body parts in the wound.
Symptoms of Rocky Mountain Spotted start 1-2 weeks after the tick bite and are usually sudden with high fever, chills, muscle aches, severe headache and vomiting. A crusted, raised, lump may be at the inoculum (insect bite) with lymph nodes swollen.

The characteristic rash of Rocky Mountain spotted fever begins 1-10 days after the onset of fever.
Small red spots begin at the extremities (hands, feet, ankles) and spread centrally (towards the trunk) while usually sparing the face.

With progression these rashes became purpuric (bleeding under the skin) so that they will not blanch with pressure.

Complications of this disease can lead to brain, kidney, liver, lung failure, and death, if untreated. Treatment is with tetracycline or a suitable alternative.
Diagnosis is on history and collection of symptoms.

Blood tests take days to develop. It is important to note that although this rash is typical, not all cases have the rash or it may be very faint or hard to see, so its absence does not rule out the disease. Prognosis related to speed of treatment so an antibiotic may be started without a specific diagnosis (many of the tick borne diseases have similar treatments).

Different types of rickettsia cause other spotted fevers and their name usually tells of their location. Avoidance, diagnosis and treatment are similar to Rocky Mountain spotted fever, although the severity of symptoms can vary between them.

Examples are:
- Mediterranean Spotted Fever
- Kenyan Tick Typhus
- African Tick Bite Fever
- Israeli Spotted Fever
- Astrakhan Fever (found in the Caspian sea),
- Siberian Tick Typhus
- Indian Tick Typhus
- Japanese Spotted Fever
- Queensland Tick Typhus
- Flinders Island Spotted Fever (Australia)

Rocky Mountain Spotted Fever Links

CDC http://www.cdc.gov/ncidod/dvrd/rmsf/ http://www.cdc.gov/ncidod/diseases/submenus/sub_rmsf.htm

Dermatology about http://dermatology.about.com/cs/infectionbacteria/a/rmsf.htm

DermAtlas http://dermatlas.med.jhmi.edu/derm/result.cfm?Diagnosis=-960590716