Mary D. Nettleman, MD, MS, MACP is the Chair of the Department of Medicine at Michigan State University. She is a graduate of Vanderbilt Medical School, and completed her residency in Internal Medicine and a fellowship in Infectious Diseases at Indiana University.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
What are risk factors for Rocky Mountain spotted fever?
Cases of RMSF occur
when the appropriate tick vector comes in contact with human populations. Risk
factors include traveling to an area with a high rate of RMSF, especially in
seasons when ticks are plentiful, such as summer. People at highest risk are
those who frequent forested areas or fields, such as those who are hiking or
camping. Even urban outdoor areas pose a risk, however. Dog ownership is a risk
factor in areas where the American dog tick exists. Dogs acquire ticks while
roaming outside, and these ticks can be transferred to humans during petting or other
contact.
The risk of RMSF is thought to increase with the duration of tick attachment.
A feeding tick can remain attached to a human for up to two weeks. Crushing an
attached tick improperly may cause secretions from the tick to be injected into
the skin and increase the risk of infection.
Severe disease is more common in the elderly, alcoholics, and in African
Americans. The latter is at least partly due to delays in diagnosis of the
typical rash in dark-skinned people. In addition, blacks are more likely to have
a genetic enzyme deficiency (G6PD) that can make the disease more severe.
What are symptoms and signs of Rocky Mountain spotted fever in children and
adults?
Symptoms appear within about a week of exposure to the bacteria (range two
to 14 days). Initially, people feel like they have influenza (flu) with
headache, high temperature, body aches, and fatigue. Other possible symptoms
include abdominal pain, vomiting, and
lack of appetite. Symptoms in children may
be slightly different than in adults. Children may complain less of headache and
more of abdominal pain, which may be severe. The eyes may be red
(conjunctivitis).
A rash appears within three to five days, often starting around the wrists or ankles
and then spreading to the trunk, palms, and soles. The rash starts as discrete,
small red areas and resembles the rashes (exanthems) of many other viral
illnesses. Over a few days, these areas may become bright red or purple and are
known as petechiae, a sign of more severe disease. The petechiae may merge as
the rash advances to create a diffuse redness.
In some cases, the rash may be so mild that it is missed on examination.
People with dark skin often have delayed diagnosis because the rash is harder to
detect. In severe cases, the skin may turn black and necrotic (meaning there is
death of tissue), resembling gangrene.
Headache is often very severe and may be the presenting complaint, especially
in adults. Other neurological signs that might appear include a stiff neck,
difficulty hearing, confusion, and weakness or paralysis of some muscles. Severe
cases may reduce the ability of the blood to clot, which causes the patient to
be at risk for internal bleeding.
None of the above symptoms is specific for RMSF. Other tick-borne illnesses
may cause similar symptoms, including other members of the spotted fever
rickettsiosis group. Ticks may also spread other diseases such as Lyme disease.
Abdominal pain is pain in the belly and can be acute or chronic. Causes include inflammation, distention of an organ, and loss of the blood supply to an organ. Abdominal pain can reflect a major problem with one of the organs in the abdomen such as the appendix, gallbladder, large and small intestine, pancreas, liver, colon, duodenum, and spleen.
The word "rash" means an outbreak of red bumps on the body. The way people use this term, "a rash" can refer to many different skin conditions. The most common of these are scaly patches of skin and red, itchy bumps or patches all over the place.
Diarrhea is a change is the frequency and looseness of bowel movements. Cramping, abdominal pain, and the sensation of rectal urgency are all symptoms of diarrhea. Absorbents and anti-motility medications are used to treat diarrhea.
Pink eye, also called conjunctivitis, is redness or irritation of the conjunctivae, the membranes on the inner part of the eyelids and the membranes covering the whites of the eyes. These membranes react to a wide range of bacteria, viruses, allergy-provoking agents, irritants, and toxic agents.
Headaches can be divided into two categories: primary headaches and secondary headaches. Migraine headaches, tension headaches, and cluster headaches are considered primary headaches. Secondary headaches are caused by disease. Headache symptoms vary with the headache type. Over-the-counter pain relievers provide short-term relief for most headaches.
Liver disease can be cause by a variety of things including infection (hepatitis), diseases such as gallstones, high cholesterol or triglycerides, blood flow obstruction to the liver, and toxins (medications and chemicals). Symptoms of liver disease depends upon the cause; however, common symptoms may include nausea, vomiting, upper right abdominal pain, and jaundice. Treatment depends upon the cause of the liver disease.
Nausea is an uneasiness of the stomach that often precedes vomiting. Nausea and vomiting are not diseases, but they are symptoms of many conditions. The causes of vomiting differ according to age, and treatment depends upon the cause of nausea and vomiting.
Although a fever technically is any body temperature above the normal of 98.6 degrees F. (37 degrees C.), in practice a person is usually not considered to have a significant fever until the temperature is above 100.4 degrees F (38 degrees C.). Fever is part of the body's own disease-fighting arsenal: rising body temperatures apparently are capable of killing off many disease- producing organisms.
Fatigue can be described in various ways. Sometimes fatigue is described as feeling a lack of energy and motivation (both mental and physical). The causes of fatigue are generally related to a variety of conditions or diseases for example, anemia, mono, medications, sleep problems, cancer, anxiety, heart disease, drug abuse, and more. Treatment of fatigue is generally directed toward the condition or disease that is causing the fatigue.
Ticks are known transmitters of disease to humans and animals. Tick-borne diseases include Lyme disease, Rocky Mountain spotted fever, Q fever, tularemia, babesiosis, and Southern tick-associated rash illness. Infected ticks spread disease once they've bitten a host, allowing the pathogens in their saliva and mouth get into the host's skin and blood. Tick bites are typically painless, but the site of the bite may later itch, burn, turn red, and feel painful. Individuals allergic to tick bites may develop a rash, swelling, shortness of breath, numbness, or paralysis. Tick bite treatment involves cleaning and applying antibiotic cream.
Blindness is the state of being sightless. Causes of blindness include macular degeneration, stroke, cataract, glaucoma, infection and trauma. Symptoms and signs may include eye pain, eye discharge, or the cornea or pupil turning white. Treatment of blindness depends upon the cause of the blindness.
Bug bites and stings have been known to transmit insect-borne illnesses such as West Nile virus, Rocky Mountain spotted fever, and Lyme disease. Though most reactions to insect bites and stings are mild, some reactions may be life-threatening. Preventing bug bites and stings with insect repellant, wearing the proper protective attire, and not wearing heavily scented perfumes when in grassy, wooded, and brushy areas is key.
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