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CDC confirms first 2009 N.C. Rocky Mountain Spotted Fever death

Release Date: July 23, 2009
Contact: Carol Schriber, 919-733-9190

RALEIGH –The Centers for Disease Control and Prevention (CDC) has confirmed that a Buncombe County man’s death in mid-May was the result of Rocky Mountain spotted fever (RMSF). The request for tissue testing at CDC took extra time, but identified the cause of death as RSMF. Influenza had also been considered as a possible cause. While deaths from this tick-borne disease are rare, an average of about 675 cases of RMSF have been reported annually in North Carolina over the last three years.

RMSF is caused by infection with the bacterial organism Rickettsia rickettsii, and is transmitted by the bite of an infected tick. The American dog tick, common on untreated dogs in North Carolina, is the main transmitter of the disease. Among tick-borne diseases in the United States, RMSF has one of the highest risks of death. While the disease can usually be treated with antibiotics, 3 to 5 percent of cases reported in the U.S in recent years have been fatal.  The best prevention is to limit exposure to ticks and tick bites.

“This death is a sad reminder that ticks in our state can carry dangerous and potentially fatal diseases,” said Acting State Epidemiologist Jean-Marie Maillard. “North Carolina and Oklahoma are the states with the highest numbers of reported RMSF cases relative to their population each year, so we need to be especially vigilant here in avoiding tick bites.”

The last Rocky Mountain spotted fever death in North Carolina occurred in 2008 in Wilkes County. There were 515 reported cases of the disease in North Carolina last year, 665 in 2007, and 852 in 2006.

According to the CDC, key symptoms are fever, muscle pain, headache and rash. Between 11 and 25 percent of reported cases in North Carolina become ill enough to be hospitalized. Some early symptoms (such as fever and muscle pain) are similar to influenza infection. Despite the increased attention to influenza, it is important to remember that other fever-causing diseases are also circulating in the state.

You can limit your exposure to ticks by:

  • Avoiding tick-infested areas if possible. Areas between fields or lawns and woods that have grasses or small shrubs are prime locations for ticks.
  • Wearing light-colored clothing (preferably with long sleeves and pants legs), which allows you to see ticks that are crawling on your clothing.
  • Tucking your pants legs into your socks so that ticks cannot crawl up the inside of your pants legs, and tucking shirttails into your waistband so ticks can't get under your shirt.
  • Applying repellents to discourage tick attachment. Repellents containing permethrin can be sprayed on boots and clothing, and will last for several days. Repellents containing DEET can be applied to the skin, but will last only a few hours before reapplication is necessary. Always follow label directions on repellents, and use with caution on children to avoid adverse reactions.

While it is possible to be bitten by a tick and not know it, most tick bites can be detected. And, if you are bitten by a tick, quick removal of the tick reduces the chance of infection. After outdoor activities, search your entire body for ticks. Use a hand-held or full-length mirror to view all parts of your body. The nape of the neck and behind the ears are especially important areas to check. Remove any tick you find on your body. Thoroughly check children for ticks, especially in the hair. Ticks may also be carried into the household on clothing and pets and only attach later, so both should be examined carefully to exclude ticks.

To remove a tick:

  • Use fine-tipped tweezers, and protect your fingers with a tissue, paper towel, or latex gloves. Avoid removing ticks with your bare hands.
  • Grasp the tick with the tweezers as close to the skin surface as possible and pull upward with steady, even pressure. Do not twist or jerk the tick; this may cause the mouthparts to break off and remain in the skin.
  • Wash the bite area well with soap and water. Also wash your hands.
  • Tape the tick to a white piece of paper or cardboard and write down the date of removal. If you develop symptoms, this could be important information to share with your doctor.

For more information about tick-borne illness see the Public Health websites at www.epi.state.nc.us/epi/tick and www.deh.enr.state.nc.us/phpm, and the CDC website at www.cdc.gov. See also how to remove a tick properly on the CDC website.