What is Rocky Mountain Spotted Fever?

RMSF is a bacterial disease caused when the bacterium R. rickettsii enters the bloodstream through the bite of an infected tick. Once there, the bacteria enter and replicate in the cells of the inner lining of small blood vessels. This causes damage to the affected cells leading to inflammation (vasculitis) and blood clots (thrombi) that can block the affected vessels. As the Rickettsia spread through the bloodstream they affect multiple organs such as skin, heart, lungs, kidneys, brain, liver and spleen, leading to diverse signs and symptoms. Since the bacteria also affects the central nervous system, its symptoms can be grave.

RMSF is spread by three types of ticks: the Rocky Mountain wood tick, the American dog tick, and the brown dog tick. Combined, the territories of these three ticks cover most of the United States and the bordering countries, including Canada and Mexico. They have also spread down to South America. So visitors to the Americas must pay attention to good tick bite protection. Additionally, knowing the symptoms of RMSF can help you seek treatment early, which may be the difference between life and death. 

Signs and Symptoms of RMSF

Symptom onset of RMSF varies between two days to two weeks after a bite by an infected tick. Early symptoms can include headache, fever, nausea, vomiting, abdominal pain, weakness, and muscle pains. Within three days, about 50% of people with RMSF develop a rash that typically starts at the ankles and wrists and then spreads to other parts of the body. However, it’s important not to wait for the rash before seeking treatment, as it does not develop in everyone with RMSF!

Further symptoms of RMSF include abdominal pain, lack of appetite and sensitivity to light.

If left untreated, more severe symptoms may develop, including:

• Shortness of breath
• Hypotension
• Confusion
• Seizures
• Anxiety, agitation, or nervousness
• Coma
• Numbness or weakness

The symptoms of RMSF are not to be taken lightly. If you notice any of those symptoms and have been in an area where RMSF is known to occur, reach out to a medical professional. 

Some people are at a higher risk of becoming severely ill with RMSF, and that includes people who:

• Are younger than 10 or older than 70 years
• Have a compromised immune system
• Have a glucose-6-phosphate dehydrogenase (G6PD) deficiency

Those who fit these traits should be on high alert for the first symptoms of RMSF since prompt treatment is crucial.

Treating Rocky Mountain Spotted Fever

Treatment of RMSF involves a course of antibiotics that generally lasts seven to 10 days. It is most effective when initiated within five days of symptom onset, which is why prompt medical attention is crucial if you develop the symptoms above and have traveled to a destination where RMSF is native. 

If your treatment is delayed, RMSF can cause severe organ damage and cause life-threatening complications such as: 

• acute kidney injury
• acute respiratory distress syndrome (ARDS)
• pulmonary edema
• heart disease
• anemia, sepsis
• internal bleeding
• partial paralysis
• gangrene
• loss of bowel or bladder control
• brain inflammation
• organ failure

Without treatment, the fatality rate of RMSF can reach 20%-30%. The fatality rate is also higher if treatment begins five or more days after symptom onset. 

Am I At Risk Of RMSF?

The good news is that unless you’re traveling to the Americas, particularly the south-central and southeastern U.S., you’re unlikely to be exposed to RMSF. However, if you do venture over to North, Central or South America, you may be at risk of RMSF, especially if you plan on spending time outside during the warmer ambient temperatures. 

While you might not be at risk of RMSF if you stay in Switzerland, there are other tick-borne diseases transmitted in our geographical area, including tick-borne encephalitis (TBE). In fact, Switzerland is now one of the top countries at risk of TBE, which in severe cases can cause infection in or around the brain and spinal cord, which may result in death. 

So be on your guard against tick bites both at home and abroad!

Protecting Yourself against Tick Bites

Whether you’re traveling or staying home, when outside there is a risk for a tick bite that may transmit an infectious disease. To protect your health, it’s best to avoid tick bites.

Here are some tips on how to prevent tick bites: 

• Wear long shirts and pants
• Wear socks and closed-toe shoes
• Tuck in your shirt into your pants and your pants into your socks
• Wear light-colored clothing to easily spot ticks
• Use insect repellant with ingredients that repel ticks (such as DEET)
• Avoid walking through tall grass, stay on cleared paths and pavement
• Shower after outdoor activities
• Check your pets for ticks if they’ve been outside

If you’re traveling to North or South America, and especially states around the Rocky Mountains, following these tips can help prevent you from becoming infected by the deadliest tick-borne disease, but also from other infections such as Lyme Disease. 

Get Vaccinated Against Tick-Borne Diseases

While preventative measures are crucial for deterring tick bites, they may still occur. Being vaccinated against tick borne infections where possible reduces your risk for contracting a severe infection. 

For those looking to protect themselves from TBE, a dangerous tick-borne disease that is common in many parts of Europe including Switzerland as well as Asia, book a “just-a-shot” appointment to quickly get protection from infections that “bite”.

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