Spotted fever: why is tick disease so dangerous?
Rocky Mountain spotted fever is an extremely rare disease, but it has a high fatality rate, especially when diagnosed late. The annual average does not exceed 100 cases. Because of this, it is common to delay in suspecting this type of infection, delaying appropriate treatment. 1
Between 2007 and 2023, Brazil had 2868 records of the disease, with 925 deaths. The highest concentration of notifications was in the Southeast region. In the first half of 2023, there was an outbreak in the state of São Paulo that increased the concern of the population and authorities. two
This shows that, despite being seen as typically rural, more urbanized and populated areas facilitate the spread of the pathogens responsible for infection. two
In this post, we will explain the main points regarding spotted fever, covering the symptoms, causes, transmission, treatment, complications and prevention methods. Keep reading!
What is spotted fever?
Spotted fever, also known as tick fever or typhus, is an infection caused by bacteria of the genus Rickettsia. These pathogens can only live in other organisms, which is why ticks are the main agents that transmit the disease. When they enter the body, they invade cells in blood vessels, which can cause clots that block circulation. 1
In Brazil, there are two species of rickettsia in circulation, which are mainly responsible for cases in the country. There are 3 of them :
- Rickettsia rickettsii: associated with Brazilian Spotted Fever, a serious infection that predominates in the Southeast region and north of Paraná;
- Rickettsia parkeri: responsible for less severe conditions, mainly in environments close to the Atlantic Forest.
The name of the disease comes from the skin rashes it usually causes, known as macules. They appear on the first day of symptoms, with a pink and flat appearance, spread over the wrists, palms of the hands, ankles, feet and forearms. 3
As the condition progresses, they can affect other parts of the body, in addition to becoming darker and more prominent. It is important to highlight that skin rashes do not occur in 100% of infections. In other words, infected people can develop the disease without this characteristic symptom. 1
In fact, this is another fact that can make the diagnosis difficult, considering that the other associated symptoms are common in other conditions. 3
As it is a bacterial disease, treatment is based on antibiotics. The sooner you start medication, the lower the risk of serious complications. Data points to a 15% reduction in the fatality rate. 3
What are the symptoms of spotted fever?
The main symptoms of spotted fever are 3 :
- High fever;
- severe headache;
- nausea;
- vomiting;
- prostration;
- diarrhea;
- abdominal pain;
- muscle aches;
- swelling and redness on the soles of the feet and palms;
- skin rashes;
- dry cough ;
- limb paralysis, difficulty breathing and mental confusion (in more severe cases).
Looking at the list of symptoms, we can see how difficult it is to differentiate the condition from other diseases. It is quite similar and confused with the following 3 :
- leptospirosis;
- dengue ;
- viral hepatitis;
- malaria;
- meningitis;
- measles;
- pneumonia;
The beginning of the picture is sudden. From one moment to the next, the temperature rises and body aches and fatigue begin. Therefore, it is possible to notice small reddish spots on the skin, as if they were bites from fleas, ticks or microscopic insects. 3
At first, they are low and pink. Over time they darken and become swollen. Without adequate treatment or combat, the tissue can die and become gangrene. 3
The first phase of the illness usually lasts six days. In total, the infection can cause persistent symptoms for up to three weeks, especially in more severe cases. It is worth pointing out that the onset of discomfort occurs between 3 and 12 days after contamination. 3
To better understand the progression of the infection, we will highlight and explain the main symptoms of tick fever. Check out!
High fever
A high fever , above 38 ºC, is one of the first signs of spotted fever infection. The increase in body temperature is sudden and persistent. In other words, it starts from one hour to the next and can download and return several times. 3
As mentioned, pyrexia can occur from the first day and, in more severe conditions, continues to appear for up to three weeks. 1
Even so, controlling the symptom is important to provide comfort to the patient. It is only necessary to confirm with the doctor which medication is safest and recommended for this treatment. 1
Severe headache
In response to the pathogen, the immune system develops inflammation of the affected tissues, which are mostly the blood vessels in the skin, subcutaneous tissue and mucous membranes lining the internal organs. 1
This process dilates the vascular ducts to facilitate irrigation and transport of defense cells to the affected area. Consequently, there is swelling in the area of infection, which is already sensitized by the action of bacteria, which compromise blood vessel cells, causing clots and obstructions. 1
With the sum of these factors, it is common for severe pain to appear throughout the body. Among the most critical points, headache is one of the most severe complaints. 1
A headache can occur due to the changes that the disease causes in the body or, more directly, due to the inflammation that affects the blood vessels around the brain. 1
As with fever, supportive treatment serves to alleviate the symptoms of spotted fever. In this case, analgesics and anti-inflammatories may be recommended by the doctor who monitors the case. 1
Malaise and fatigue
The inflammatory condition can affect the entire body, causing generalized discomfort that lasts for much of the duration of the symptoms. Limbs become sore and any movement requires a lot of effort. 1
Because of this, fatigue and prostration are also among the main complaints of those infected with spotted fever. The person becomes depressed, unwell and looks sick, which is directly related to the impact caused by the pathogen and the ability of the immune system to fight it. 1
In general, resting, taking care of your diet and drinking plenty of water are the best recommendations for dealing with the situation. 1
Nutrient intake is essential to replenish the body with vitamins and minerals important for its maintenance. Fluid replacement, in addition to contributing to self-care, helps reduce the risk of dehydration associated with fever. 1
Finally, rest is a containment measure to minimize tiredness and energy expenditure in everyday life, preserving the body’s strength to properly deal with the infection. 1
Muscle aches
Muscle pain is the result of inflammation of the body’s tissues, considering that spotted fever is systemic, that is, it is not limited to a single area of the body. In this case, both muscles and tendons, nerves and joints can be affected. 3
As explained previously, this discomfort is related to intense fatigue and the effort used by the body to prevent the proliferation of bacteria, through the production of defense cells, such as antibodies and white blood cells. 3
Also according to what has been said, it is important to rest a lot and avoid activities that require physical strength. This way it is possible to save energy, minimize damage and reduce the risk of domestic accidents, such as falls. 3
Rashes or spots from spotted fever
Rashes caused by Rocky Mountain spotted fever occur due to infection of the vascular tissue cells in the skin, both in the upper and lower layers. At first, the spots are flat and have a pinkish or slightly reddish color. 3
With time and the evolution of the situation, this will change. They turn an intense red tone, especially when clots form in the affected cells, in addition to becoming more prominent. 3
Spots and rashes begin to appear on the wrists, ankles, hands, feet and arms. However, within a few days, they spread to the trunk, neck, buttocks, legs and abdomen. If the infection continues to progress, the damage is more significant and the tissue may darken. 3
More serious cases may develop gangrene, with the fingers and ear tips being the most vulnerable areas. 3
Nausea and vomiting
Nausea and vomiting are very common symptoms of spotted fever. The digestive tract becomes irritated and sensitive, which favors the feeling of intense nausea. In general, it is common to notice a considerable loss of appetite, as well as greater sensitivity to certain foods and strong seasonings. 3
As we know, it is essential to eat well to meet the body’s nutritional demands and not feel even more weak due to the lack of vitamins. Therefore, it is necessary to take measures to overcome the discomfort. 3
As with the diet recommended for colds and flu, lighter and fluid foods, such as soups, broths and chicken soups, are easier to swallow. Vegetables need to be well cooked and, preferably, it is better to opt for lean meats, such as chicken. 4
Fruits and cereals are also valid alternatives. In general, just avoid excess and heavy foods, such as fatty and ultra-processed foods. 4
This diet does not cure or alleviate symptoms, but is recommended to recover reserves of essential vitamins and minerals, helping to restore health after the condition improves. 4
Finally, it is worth highlighting the importance of hydration during this period, especially if you suffer from vomiting and diarrhea. These symptoms accelerate fluid loss. Therefore, you need to drink more fluids to compensate for what was eliminated by the body and avoid dehydration. 4
Abdominal pain
Often those infected with spotted fever complain of severe abdominal pain. This discomfort is related to systemic inflammation, discomfort in the gastrointestinal tract and the body’s difficulty in maintaining essential biological functions during the acute condition. 3
The discomfort is felt in both the muscles and internal organs. In this case, cramps usually accompany diarrhea and cause prostration, when the person becomes down, discouraged and without the strength to get up. 3
As mentioned, fluid replacement is very important to deal with the case, as it prevents severe dehydration. In addition, analgesics and antiemetics can be prescribed by the doctor, as part of treatment support. 4
Sensitivity to light (photophobia)
The headache caused by spotted fever can result from inflammation in the tissues of the nervous system. Under these conditions, sensory stimuli can overload brain cells and, in addition to pain, cause temporary hypersensitivity. 1
Odors and loud sounds are among the causes of this discomfort. However, photophobia, sensitivity to light, tends to be more impactful. Both natural and artificial lighting can cause discomfort and trigger headaches. 1
Therefore, in addition to using analgesics to alleviate the pain, it may be recommended to stay in dark environments or with diffused light, so as not to make the sensation worse. 1
Edema (swelling)
Inflammation of blood vessels is also responsible for the formation of edema in spotted fever. This excessive swelling is noticed mainly in the hands and feet, compromising the patient’s motor capacity, as the area becomes painful and sensitive. 1
The mechanism behind the symptom is similar to that of skin rashes, so it can be combatted with the help of analgesics and anti-inflammatories. 1
Mental confusion or changes in consciousness
When bacteria of the genus Rickettsia reach the blood vessels of the brain, they can cause changes in the state of consciousness. This tends to occur in more serious infections that go untreated for a long time. 1
Under these conditions, the functioning of the nervous system is compromised, causing agitation, mental confusion, delirium and insomnia. In more severe cases. It can even leave the patient in a coma. 1
It is also worth pointing out that this condition impairs the ability to coordinate essential biological functions. Consequently, there may be paralysis, which begins in the lower limbs and gradually increases. If it reaches the lungs, it can cause respiratory arrest and heart damage. 1
How is spotted fever transmitted?
Spotted fever is transmitted through the bite of ticks infected with the rickettsia bacteria. Because this pathogen needs an organism’s cells to survive, it is not found widely in the environment. 1
In general, in a region with a high incidence, the tick becomes infected when it feeds on the blood of a mammal previously infected by the bacteria. From there, it lives in the parasite’s body and can be inoculated into other individuals when it feeds again. 1
It is extremely unlikely for spotted fever to be transmitted from one person to another. Typically, the risk is greater in areas with greater movement of wild animals, such as capybaras and tapirs. 1
On the other hand, urban areas are heavily affected by the presence of infected rodents, which can spread the tick, along with the bacteria, to pets and humans. 1
What should I do if I suspect I have spotted fever? How is the diagnosis made?
Timely treatment is one started in the first phase of the disease, capable of preventing the proliferation of bacteria and, consequently, reducing the impact of the infection on the body. However, as seen, spotted fever is difficult to diagnose. 1
Because it is not so common and shares symptoms with other clinical conditions, suspicion usually takes a while to be raised. In general, the doctor evaluates the condition and interviews the patient to verify this possibility. 3
As the bacteria is more common in forested areas, rural areas and, in urban centers, in poorer regions, with a lack of basic sanitation, the specialist usually asks where the person lives, if they have visited a risk area recently, if they have animals pet, among other relevant data. 3
At this point, he can already propose preventive treatment, in addition to carrying out laboratory tests to finalize the diagnosis. There are 3 specific tests for spotted fever :
- indirect immunofluorescence reaction;
- immunohistochemistry examination;
- molecular biology technique;
- bacteria isolation.
In addition to these, there are general exams that can complement the diagnostic strategy, 3 of which are :
- blood count;
- enzyme tests.
As some of these tests can take weeks to return results, the doctor may not wait for completion to begin treatment. This largely depends on the severity of the condition, the risk of complications, the response to other medications and the probability of exposure to the transmitting tick. 3
How is the disease treated? Does she have a cure?
Spotted fever has a cure. The disease is treated with specific antibiotics to combat Rickettsia-type bacteria. The main recommended medication is doxycycline, administered orally in mild cases and intravenously in more serious infections. 3
The duration of treatment lasts from 7 to 14 days, on average. Normally, the doctor only suspends the use of the medicine after the patient does not have a fever for a period of 24 to 48 hours. 3
Furthermore, as mentioned, there is the possibility of starting supportive care to alleviate symptoms, with the use of analgesics, anti-inflammatories and antiemetics. Depending on the situation, hospitalization with fluid replacement directly into the vein may be necessary. 3
In any case, it is not recommended to take medication on your own. The best thing to do is look for a health unit to obtain medical advice. Remembering that treatment for spotted fever is provided by the SUS. 3
What tick transmits spotted fever? What does he look like and where does he usually stay?
Only ticks of the Amblyomma genus are capable of transmitting spotted fever. Among them, the most common is the star tick, Amblyomma sculptum. Only the youngest individuals of this species bite humans. 5
These parasites inhabit forest areas, rural and urban areas, mainly where they find mammals that they use for food, such as rats, capybaras, horses and the like. Pets can contract ticks when traveling through these places, especially near vacant lots. 5
How to prevent the disease
Prevention against spotted fever is carried out through the following measures 5 :
- avoid traveling through areas of high vegetation and endemic regions that have been marked;
- when hiking and visiting forest areas, wear pants, boots and long-sleeved shirts, covering as much skin as possible;
- wear light-colored clothes and check your clothes for the presence of ticks after visiting a risk area;
- when you notice the parasite on your skin, use tweezers, gloves or a piece of paper to remove it;
- Without these items at your disposal, pick up the tick with your fingertips, twist and pull until it is completely removed;
- use diethyltoluamide repellents;
- keep pet deworming up to date;
- use tick collars on dogs and cats;
- avoid accumulation of debris, especially decaying leaves and wood;
- combat rodent infestations in urban areas.
Is spotted fever contagious?
The transmission of spotted fever occurs mainly through the bite of the star tick, which is responsible for the spread of rickettsia among mammals. Transmission from one person to another is extremely unlikely, but possible. 1
Can spotted fever cause death?
Yes, according to data presented, spotted fever was responsible for more than 900 fatalities between 2007 and 2023, with around 800 deaths in the Southeast region alone. Although there is a cure, through the use of specific antibiotics, timely diagnosis at the beginning of the disease is rare. two
What is the relationship between capybaras and spotted fever?
Capybaras are common rodents in urban areas of the Southeast and are quite common hosts of the star tick, which caused them to be blamed for the spotted fever outbreak in 2023, which caused fatalities in the first half of the year. 6
As these animals normally move through forest environments, they are more susceptible to the parasite. Therefore, avoiding proximity to the species is recommended. However, it is worth pointing out that other common animals in urban life can also suffer from this infestation. 6
This is the case with horses, cats and dogs. Therefore, it is essential to monitor the areas your pets frequent, avoid tall vegetation, use anti-tick collars and keep deworming up to date. 6
Is there a vaccine against spotted fever?
There is no vaccine against spotted fever. In the 1930s, research to develop the vaccine began, but did not bring results. Two scientists involved in the project were victims of accidental contamination and died. 5
During that time, specific antibiotics were discovered to combat rickettsia. This decreased demand for a vaccine, and the study was discontinued. 5
Conclusion
Rocky Mountain spotted fever is a rare and very serious disease. Diagnosis is made difficult by a series of factors, but it is possible to initiate preventive care quickly, by evaluating the context of the symptoms presented by patients.
The recent outbreak is proof that prevention and care are imperative, but this does not mean there is reason for panic or drastic actions, such as slaughtering potential hosts.
With the right habits, attention to symptoms and prompt treatment, the chances of a cure are very good. In addition, supportive care is valid to preserve the body, regain strength and alleviate symptoms.
However, don’t forget to consult your doctor for recommendations on medications to treat the headache, nausea and malaise associated with spotted fever.
We hope you enjoyed the post and learned more about the disease. To the next!
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