Rocky Mountain spotted fever

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Rickettsia rickettsii
Scientific classification
Kingdom: Bacteria
Phylum: Proteobacteria
Class: Alpha Proteobacteria
Order: Rickettsiales
Family: Rickettsiaceae
Genus: Rickettsia
Species: R. rickettsii
Binomial name
Rickettsia rickettsii
Wolbach, 1919

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Rocky Mountain spotted fever Microchapters

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Overview

Historical Perspective

Pathophysiology

Epidemiology & Demographics

Risk Factors

Screening

Causes

Differentiating Rocky Mountain spotted fever

Complications & Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory tests | Electrocardiogram | X Rays | CT | MRI Echocardiography or Ultrasound | Other images | Alternative diagnostics

Treatment

Medical therapy | Surgical options | Primary prevention | Secondary prevention | Financial costs | Future therapies

Prevention

Primary Prevention

Tuck pants into socks

Limiting exposure to ticks reduces the likelihood of infection with Rocky Mountain spotted fever. In persons exposed to tick-infested habitats, prompt careful inspection and removal of crawling or attached ticks is an important method of preventing disease. It may take extended attachment time before organisms are transmitted from the tick to the host.

It is unreasonable to assume that a person can completely eliminate activities that may result in tick exposure. Therefore, prevention measures should emphasize personal protection when exposed to natural areas where ticks are present:

  • Wear light-colored clothing which allows you to see ticks that are crawling on your clothing.
  • Tuck your pants legs into your socks so that ticks cannot crawl up the inside of your pants legs.
  • Apply repellents to discourage tick attachment. Repellents containing permethrin can be sprayed on boots and clothing, and will last for several days. Repellents containing DEET (n, n-diethyl-m-toluamide) can be applied to the skin, but will last only a few hours before reapplication is necessary. Use DEET with caution on children. Application of large amounts of DEET on children has been associated with adverse reactions.
  • Conduct a body check upon return from potentially tick-infested areas by searching your entire body for ticks. Use a hand-held or full-length mirror to view all parts of your body. Remove any tick you find on your body.
  • Parents should check their children for ticks, especially in the hair, when returning from potentially tick-infested areas. *Ticks may also be carried into the household on clothing and pets and only attach later, so both should be examined carefully to exclude ticks.

Secondary Prevention

Tick Control

Strategies to reduce populations of vector ticks through area-wide application of acaricides (chemicals that will kill ticks and mites) and control of tick habitats (e.g., leaf litter and brush) have been effective in small-scale trials. New methods being developed include applying acaricides to animal hosts by using baited tubes, boxes, and feeding stations in areas where these pathogens are endemic. Biological control with fungi, parasitic nematodes, and parasitic wasps may play supportive roles in integrated tick control efforts. Community-based, integrated, tick-management strategies may prove to be an effective public health response to reduce the incidence of tick-borne infections. However, limiting exposure to ticks is currently the most effective method of prevention of tick-transmitted diseases.

History

Rocky Mountain spotted fever was first recognized in 1896 in the Snake River Valley of Idaho and was originally called “black measles” because of the characteristic rash. It was a dreaded and frequently fatal disease that affected hundreds of people in this area. By the early 1900s, the recognized geographic distribution of this disease grew to encompass parts of the United States as far north as Washington and Montana and as far south as California, Arizona, and New Mexico.

Howard T. Ricketts was the first to establish the identity of the infectious organism that causes this disease. He and others characterized the basic epidemiological features of the disease, including the role of tick vectors. Their studies found that Rocky Mountain spotted fever is caused by Rickettsia rickettsii. This species is maintained in nature by a complex cycle involving ticks and mammals; humans are considered to be accidental hosts and are not involved in the natural transmission cycle of this pathogen. Tragically—and ironically—Dr. Ricketts died of typhus (another rickettsial disease) in Mexico in 1910, shortly after completing his remarkable studies on Rocky Mountain spotted fever.

References

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

External links

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