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Posted: July 24 2018 at 5:18am |
Wisconsin reports first death from Rocky Mountain spotted feverJuly 13, 2018 (CNN)An uncommon but potentially deadly disease is on the rise in the United States. Rocky Mountain spotted fever is the deadliest tick-borne illness in the world, according to the US Centers for Disease Control and Prevention, though access to antibiotics has lowered fatality rates from 28% in 1944 to less than 0.5% today. Rocky
Mountain spotted fever can be spread to humans through the bite of an
infected tick. The disease itself is caused by the bacterium R.
rickettsii, which belongs to a genus of bacteria that cause typhus and
other forms of spotted fevers. Rocky Mountain spotted fever was
discovered in 1906 by Howard Ricketts, who later died of rodent-carried
typhus, a related disease. Although
the majority of cases of the disease are reported in North Carolina,
Tennessee, Oklahoma, Arkansas and Missouri, Rocky Mountain spotted fever
can occur in virtually every US state. The Wisconsin Department of Health Services confirmed on Tuesday the first documented death in the state
due to the disease. Rebecca Osborn, a disease pathologist who
investigated the Wisconsin woman's death, said that although any
fatality is a concern to public health specialists, the death does not
necessarily indicate increased risk of contracting the disease in
Wisconsin. The
incidence of spotted fever rickettsiosis, a category that includes
Rocky Mountain spotted fever, has increased from fewer than 2 cases per
million people in 2000 to over 11 in 2014, according to the CDC. And vector-borne diseases, those spread by such creatures as mosquitoes, ticks and fleas, have nearly tripled since 2004, the CDC reported in May. Vector-borne
diseases account for more than 17% of all infectious diseases and cause
more than 700,000 deaths annually around the globe, according to the World Health Organization. Rocky Mountain spotted fever symptomsSeveral
species of ticks can spread the disease, including American dog ticks,
which are found east of the Rocky Mountains and on the Pacific Coast;
Rocky Mountain wood ticks, found in Rocky Mountain states; and brown dog
ticks, found worldwide. Rocky
Mountain spotted fever can present at first like a number of common
illnesses, with symptoms that can include fever, headache and
gastrointestinal illness. Two to five days after symptoms begin, an
individual might develop a rash. According
to Jo Foellmi, a public health nurse for La Crosse County, Wisconsin,
the woman who recentlycontracted the disease was probably bitten by an
American dog tick while she and her family were camping. She developed
nausea, vomiting, diarrhea and a stomachache in addition to a rash, the
telltale sign of the illness. However,
not all patients with the disease have a rash, and the rash can vary
greatly in its presentation, making diagnosis difficult, said Dr. Daniel Sexton, a professor of medicine at the Duke University School of Medicine who specializes in infectious diseases. To
complicate matters, up to 40% of people who contract Rocky Mountain
spotted fever don't remember being bitten by a tick, so it is important
to monitor symptoms and tell a health provider if you have been in
places where ticks are common, such as heavily wooded areas with tall
grass. The illness is especially important to look for in children, since they are five times more likely than adults to die from Rocky Mountain spotted fever, according to the CDC. Additionally, mortality rates are higher for African-Americans, males and those who live in the Rocky Mountain region for reasons that are still unknown. Since ticks are most active in the summer, most cases of the disease are reported between May and August. Treatment and preventionThe
antibiotic doxycycline is the best treatment for Rocky Mountain spotted
fever for children and adults who have been infected. Doxycycline
treats all tick-borne pathogens, many of which present similarly at
first, Sexton said. Doxycycline is most effective when used in the first five days of illness. Since
there is no vaccine for Rocky Mountain spotted fever, the best way to
prevent the disease is to avoid areas where ticks are common, check for
ticks on your clothing or your body and use insect repellent that
contains DEET. "This is an issue of
public awareness," Foellmi said, adding that people who spend time
outside should check themselves, family members and pets for ticks and
that hikers should stay on the trail to avoid encountering ticks. Most
ticks aren't infected with the bacterium that causes spotted fever, so a
tick bite without any symptoms is not cause for concern, Sexton said. |
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