Rocky Mountain Spotted Fever

It used to be thought this tick illness was West of the Rockies. It has been found in the Midwest and the South also. This author had a case from Wisconsin seven years ago in the Door County region.

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Rocky Mountain Spotted Fever (RMSF) is transmitted by the dog tick. The dog tick is also noted for transmitting Tularemia ( rabbit fever) and Tick Paralysis. RMSF can be fatal if not treated rapidly. It should be noted that before tetracyclines were on the market the fatality rate was 20-80%.

An example of the progression of this one tick Bourne illness we will discuss Wisconsin. The first case of RMSF in Wisconsin was in 2009. In 2016 there were 18 cases, 2017, 21 cases and in 2018, 27 cases.

I personally treated a case of a seven year old child who went camping for a weekend in Door county, Wisconsin. The case was profound as once you see this rash you will never forget it. It is generalized and is on the palms and soles of the feet as in secondary syphilis. Treatment is straightforward and patients usually make a full recovery.

Incubation period

3-12 days and it is important to note 10% of patients never display a rash.

Signs and Symptoms


RMSF and all the rickettsioes tick illness are treated with Doxycycline. These illnesses are RMSF, Anaplasmosis, and Ehrlichiosis

* Important to note in RMSF due to the severity of this illness Doxycycline has been approved by the CDC for the treatment in children.