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Rocky Mountain Spotted Tick Fever
Typhus-like disease first described in the Rocky Mountain section of the United States, caused by a specific microorganism (Rickettsia rickettsii) and transmitted to man by ticks. It is identical with a disease known as São Paulo fever in Brazil and with the spotted fever of Colombia. Discovery of the microbe of Rocky Mountain spotted fever in 1906 by H.T. Ricketts led to the understanding of other rickettsiae-caused diseases.
The predominance of the disease in western North America among persons exposed to the open range, and its seasonal limitation to late spring and early summer months, were explained when the carrier species was identified as a wood tick, Dermacentor andersoni, widely distributed in the adult form upon large mammals, particularly cattle and sheep. The occurrence of the human disease in the eastern and southern United States was explained when it was discovered that the common dog tick, Dermacentor variabilis, which attacks man, also acts as a carrier. In the southwestern United States, human cases were also traced to the lone star tick, Amblyomma americanum. In Brazil the common carrier is Amblyomma cajennense.
The clinical course of the disease is essentially similar to that of typhus fever. In severe cases of spotted fever the rash tends to be more hemorrhagic and to be accentuated on the extremities, particularly about the wrists and ankles. Nervous and mental symptoms are common; restlessness, insomnia, disorientation, and delirium are frequent manifestations of involvement of the central nervous system. Prostration may be marked from the beginning, merging into coma with death possible as early as the sixth or seventh day. Convalescence is likely to be slow and may be complicated by visual disturbances, deafness, and mental confusion. Although the patient's recovery may be delayed, it is usually complete. The case-fatality rates, as in typhus, vary directly with age.
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