When you think of a nasty tick bite, your mind probably jumps to Lyme disease—a bacterial infection that causes flu-like symptoms. But the truth is, several tick-borne diseases have been on the rise in the United States for several years, according to the Centers for Disease Control and Prevention (CDC). While Lyme is the most common by far, another serious infection is starting to make its mark: Rocky Mountain spotted fever (RMSF).
More than 37,000 cases of RMSF have been reported to the CDC from 2004 to 2016. In fact, most recently, a Wisconsin woman in her late 50s died just days after being diagnosed with RMSF in June, the Twin Cities Pioneer Press reports.
RMSF is a disease caused by a spotted fever group of bacteria called rickettsia, according to the CDC. It’s most commonly transmitted through infected American dog ticks, brown dog ticks, or mountain wood ticks. Despite its name, Colorado doesn’t seem to be the main hotspot for the disease: most reports stem from North Carolina, Tennessee, Missouri, Arkansas, and Oklahoma.
Because RMSF progresses rapidly, it can be life-threatening. The tricky part is catching it early, so learning to recognize the warning signs is crucial. Here’s everything you need to know about RMSF—and how to protect yourself from ever having to deal with it in the first place.
What are the symptoms of Rocky Mountain spotted fever?
The problem with RMSF is that its earliest signs don’t seem like too much to worry about—in fact, they’re also quite similar to the flu. But because the disease can be deadly, it’s crucial to diagnose it as soon as possible, says the CDC. Keep an eye out for the following symptoms, especially if you feel a fever coming on after hanging out in a tick-friendly environment (think: wooded or high brush areas). They usually pop up 2 to 14 days after being bitten:
- Fever and chills
- Headache
- Confusion or hallucinations
- Sensitivity to light
- Rash on the skin
- Nausea, diarrhea, or vomiting
- Stomach or muscle pain
- Lack of appetite
While a rash doesn’t affect every person infected, it is still the most telltale sign of RMSF and can vary in appearance from person to person. Some turn red and splotchy while others look like pinpointed dots on the skin (usually 1 to 5 millimeters in size), typically starting at the palm of your hands or the soles of your feet, according to the U.S. National Library of Medicine.
How is Rocky Mountain spotted fever treated?
RMSF treatment needs to be administered quickly to avoid complications. If you're showing symptoms, your doctor may do some blood tests to verify that you're infected, but you will probably be prescribed antibiotics before your results come back due to the aggressive progression of the disease.
The most effective treatment is a round of doxycycline—a type of antibiotic that can keep the disease from turning deadly—ideally within five days of experiencing symptoms, says the CDC. Other antibiotic options include tetracycline, or chloramphenicol if you’re pregnant.
⚠️ About 3 percent of RMSF cases are fatal, because the infection can lead to brain damage, heart, lung, and kindey failure, or meningitis when left untreated.
The good news is, most people make a full recovery when treatment is given within 5 days of infection. If it's delayed, complications can be very serious, and include inflammation of the brain, heart, or lungs, kidney failure, serious infection, and even death.
How can you protect yourself from Rocky Mountain spotted fever?
The National Institutes of Health estimates that only 1 in 1,000 dog and wood ticks carry the bacteria related to RMSF. If you do get a bite, your chances of infection aren’t as high if the tick has been latched onto you for less than 20 hours. (Here’s the right way to remove a tick if you do find one on your body.)
That doesn’t mean RMSF isn’t a real concern, though, because there’s no vaccine to prevent it. The best thing you can do to stay healthy while you spend time outdoors this summer is to prevent tick bites in the first place. Here are a few measures you can take to keep the blood-sucking bugs at bay:
- Cover up with long-sleeved shirts and pants if you’re hanging out in the woods or other grassy areas.
- Look for a tick repellent that contains at least 20 percent DEET, IR3535, picaridin, or oil of lemon eucalyptus. Before you buy, make sure it is approved by the Environmental Protection Agency. Spray your clothes and exposed skin when you venture outdoors.
- Treat your clothing, gear, or tents with permethrin (a type of insecticide) up to 48 hours before you head out. Look for a repellent that contains at least 0.5 percent, like this one from Sawyer.
- Shower after spending time outdoors and do a full body check for the critters. Pay extra attention to your underarms, ears, inside your belly button, behind your knees, between your legs, and in your hair.
- Scan your pets, as many ticks get into your home this way.
- Dry your clothes on high heat for 10 minutes to kill any ticks that may be left on your clothing. If you need to wash, use hot water and dry for at least an hour.
The Best Tick Repellents to Protect You From Bites
Pros
- Easy to apply
- Long lasting
Cons
- Strong scent
OFF! Deep Woods Insect Repellent V offers up long-term protection against a slew of biting insects, including mosquitoes, gnats, black flies, and, yup, ticks. The repellent is aerosolized, making it easy to cover your body quickly. It also features 25% DEET for maximum protection.
Pros
- No strong smell
- Long protection range
Cons
- Pricey
Sawyer’s spray offers an impressive 12 hours of protection against mosquitoes and ticks, and a little less (eight hours) against flies, gnats, and chiggers. It’s fragrance free—a big perk for people who can’t stand the smell of bug spray—and contains 20% picaridin. It's also aerosolized and goes on evenly.
Pros
- No bug spray fumes
- Maximum protection
Cons
- Need to wash hands after applying
Sure, these wipes are technically designed to repel mosquitoes but they’re effective against ticks, too. Repel’s wipes go on easy—simply rub the 30% DEET-containing cloths over your skin. There’s no need to hold your breath to avoid breathing in bug spray fumes! You'll get 20 clothes per pack—plenty to cover you and your family.
Pros
- Not aerosolized
- Strong protection
Cons
- Too strong for everyday use
Ben’s Tick & Insect Repellent uses highly-concentrated DEET (98%, to be exact). While Dr. Russo says a level of DEET this strong isn't needed or recommended for everyday use, it can be helpful to spray on your clothes or if you're in areas where the ticks are really bad. This spray offers up 10 hours of protection and is also dispensed in an environmentally-friendly pump form.
Pros
- Long-lasting protection
- Goes on gently
Cons
- Strong scent
Enjoy up to 12 hours of protection with Natrapel’s picaridin insect repellent. This spray features 20% picaridin to repel ticks, mosquitoes, gnats, and other biting insects. The brand’s bottle also dispenses a fine mist that’s easy to apply to your whole body.
Pros
- Odorless
- Low price
Cons
- Less coverage time than some other brands
Not everyone can tolerate the classic smell of bug spray. Coleman’s Skin Smart Insect Repellent is odorless, so you can get the protection you need without the lingering scent. This spray—which features 20% IR3535 as the active ingredient—has a handy twist-locking cap to keep it from going off in your bag. It also offers up to eight hours of coverage.
Pros
- Nice scent
- Environmentally-friendly pump
Cons
- Lower coverage time
Repel’s Lemon Eucalyptus Natural Insect Repellent is perfect for people who want a more “natural” approach to bug spray. It features oil of lemon eucalyptus to ward off ticks, mosquitoes, and other biting insects for up to six hours. The smell is also delicious.
Pros
- Inexpensive
- Nice scent
Cons
- Smell can be too strong for some
Cutter Lemon Eucalyptus Insect Repellent also has a nice lemony scent many people can get behind thanks to its 30% oil of lemon eucalyptus formulation. The spray repels biting insects for up to six hours and features an environmentally-friendly pump dispenser.
Alisa Hrustic is the deputy editor at Prevention, where she leads the brand’s digital editorial strategy. She’s spent the last five years interviewing top medical experts, interpreting peer-reviewed studies, and reporting on health, nutrition, weight loss, and fitness trends for national brands like Women’s Health and Men’s Health. She spends most of her days diving into the latest wellness trends, writing and editing stories about health conditions, testing skincare products, and trying to understand the next greatest internet obsession.
