A young Harrisburg-area child recently died of Rocky Mountain Spotted Fever, which is carried by dog ticks but seldom seen in Pennsylvania.
UPDATE: Family believes Lillian Rose Bennett contacted the disease in the Harrisburg area.
Graham Hetrick, the coroner in Dauphin County, where the child died, said it was the first case he's seen since becoming coroner in 1990.
Rocky Mountain Spotted Fever can cause severe illness but usually isn't fatal, although it's critical that treatment with antibiotics begins within a few days after symptoms appear.
This is one of the types of ticks that carry Rocky Mountain Spotted Fever. (Source: U.S. Centers for Disease Control and Prevention)
However, the early symptoms of Rocky Mountain, which include fever, headache and muscle pain, are similar to those of the flu and viruses. Because Rocky Mountain isn't common in Pennsylvania, and because the rash associated with the disease doesn't always appear, a Pennsylvania doctor might not immediately suspect Rocky Mountain, said Dr. George McSherry, a pediatric infectious disease specialist at Penn State Hershey Children's Hospital.
"You have to sort of put everything together, and sometimes we don't know they've been bitten [by a tick], so that's another problem," McSherry said. Knowing there was a tick bite, or that the patient had been in a state were Rocky Mountain is more common, can help doctors make the correct diagnosis, he said.
Doxycycline is the antibiotic commonly used to treat Rocky Mountain.
In recent years, the number of cases of Rocky Mountain in Pennsylvania has ranged from 23 probable or confirmed cases in 2009 to 41 probable or confirmed cases in 2012 to 16 probable cases last year, according to the Pennsylvania Department of Health. Nationally, about three percent of people who come down with the disease die, with young children slightly more likely to die, McSherry said.
Rocky Mountain Spotted Fever is present in most of the United States. However, North Carolina, Tennessee, Missouri, Oklahoma and Arkansas account for 60 percent of cases, according to the U.S. Centers for Disease Control and Prevention. During the past decade, there has been a rise in cases in a part of eastern Arizona that hadn't previously seen many cases, with the rise attributed to free-roaming dogs.
The main symptoms include fever, headache, abdominal pain, muscle pain, fatigue and vomiting. Some people also get a pink rash that might begin on the hands, wrists and ankles and spread toward the center of the body. Treatment is most effective when begun before the fifth day of symptoms.
Rocky Mountain affects the cells that line the blood vessels, causing the vessels to leak. The disease can potentially affect organs including the heart and lungs, the kidneys, the liver and the spleen, McSherry said. If treatment begins early, patients can recover in a week, he said.
The best way to avoid Rocky Mountain Spotted Fever is to avoid ticks and tick bites.
The CDC advises:
- Use repellent
- Avoid wooded or bushy area with high grass and down leaves; the tick threat is greatest during the summer
- Walk in the center of trails to avoid brushing plants were ticks wait to latch onto animals
- Bathe or shower after coming indoors to wash away ticks and more easily find ticks
- Use a mirror to check the full body for ticks
- Check children for ticks, including under their arms, in an around their ears, inside the belly button, under the arms and between the legs and, especially, in the hair
- Check pets for ticks
- Put tick collars on dogs
- Check clothing and equipment for ticks