Shaina Farfel: This is definitely something that I think most people would want to try and prevent.
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There is an antibiotic called "doxycycline" that is extremely active against this infection and is indicated for folks with a high probability. If the suspicion is there, we tell providers that the safest thing to do is go ahead and treat, and the good news is it is a very treatable disease. So, we don't recommend waiting to give therapy or treatment for a positive test. So, specifically, folks with Rocky Mountain Spotted Fever often will have low platelet counts or elevated hepatic enzymes and those might be indirect clues for this illness, but often the diagnostic tests, which are antibody tests, are delayed. There are also blood tests that can be suggestive. Karen Bloch: We do recommend that folks who either have a known tick exposure, or even in the absence of a known tick exposure, who experience symptoms like fever, seek medical attention, and I think the provider can get a history that may suggest the disease. Shaina Farfel: If I had a tick bite and I was starting to develop some of these symptoms, and was potentially concerned about whether or not I had Rocky Mountain Spotted Fever, what would you suggest that I do, and is it treatable? And just as the name implies, it is a spotted rash with bright red spots. The rash typically starts around the wrists or ankles and then spreads sort of centrally towards the belly and often will spare the face. So, the absence of a rash doesn't disprove that this is the illness. This often will come on, though, after the onset of fever. The thing that is most pathognomonic for Rocky Mountain Spotted Fever is the rash. If you have been outside or had a tick on you, the symptoms that I would recommend folks pay attention to would be the onset of fevers, chills, muscle aches, sort of a flu-like illness happening outside of the traditional flu period. So, we don't recommend treating or prophylaxing patients who have had a tick on them just by virtue of the exposure. On the other sort of side of the coin is that most of these ticks don't carry the disease. So, I would like to reassure folks that if they have a tick on them and it has been there for less than six hours, the risk of developing this disease is extremely small. Karen Bloch: Well, the first thing I want to make clear is that the tick has to be attached for a significant period of time. And so, what would I look out for? What kind of signs and symptoms would we expect from this disease? So, Tennessee is often a high prevalence area and in fact, there was something called the Rocky Mountain Spotted Fever Belt that extends from North Carolina to Oklahoma, transversing through Tennessee, so, we certainly are in an area where we could expect to see this disease. It was actually initially described in the Rocky Mountain area, but is most prevalent, actually, in the southeast United States. Karen Bloch: It can be found throughout the United States, but the name "Rocky Mountain Spotted Fever" is a bit of a misnomer. Shaina Farfel: Where is Rocky Mountain Spotted Fever most prevalent? Can folks be exposed to it here in Tennessee? So, it is a tick that we see commonly and it is a disease that we see not infrequently this time of year. Karen Bloch: Rocky Mountain Spotted Fever is a disease that is spread by ticks, and specifically in our part of the country, by the American Dog Tick. Could you tell us a little bit about Rocky Mountain Spotted Fever and how it is transmitted? Today, I wanted to speak with you about one such disease, which is known as Rocky Mountain Spotted Fever. And being outside does increase our risk for exposure to different insects and bugs, which can carry disease. We are maybe swimming in the local swimming holes, taking hikes. Shaina Farfel: We are in the middle of another hot Nashville summer.
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Karen Bloch, Associate Professor of Medicine and Health Policy and Medical Director for the General Infectious Disease Clinic at Vanderbilt University. I'm Shaina Farfel with Occupational Health. Shaina Farfel: Welcome to this edition of the Vanderbilt Health and Wellness wellcast. She discusses the prevalence of Rocky Mountain Spotted Fever and how it can be prevented. Karen Bloch, Associate Professor of Medicine and Health Policy and Medical Director for the General Infectious Disease Clinic at Vanderbilt University. Shaina Farfel with Occupational Health discusses Rocky Mountain Spotted Fever, a tick-borne disease, with Dr. Your browser does not support the audio element.