Travel Reference
In-Depth Information
Tetracycline and doxycycline are the preferred agents for uncomplicated cases and
should be given orally. Severe cases, particularly during pregnancy, should be treated with
chloramphenicol underclosemedical supervision.Generalmeasuressuchasbedrest,fluid
replacement, antifever medication if needed, and medication for sleep are also important.
Rocky Mountain spotted fever can be prevented when in an endemic area by careful
daily inspection for ticks. If any ticks are found, they should be firmly grasped with fine-
tipped tweezers as close to the skin as possible and pulled away with a steady motion
perpendicular to the skin. Any remaining body parts should be scraped away, and the
wound should be cleansed carefully. Individuals moving about in brush in an endemic area
should keep their shirtsleeves rolled down with the cuffs buttoned. Shirt collars should be
buttoned, heads should be covered, and long trousers should be closed by gaiters or tucked
into boot tops. No reliable vaccine is available.
More
information
is
available
at
www.cdc.gov/ticks/diseases/
rocky_mountain_spotted_fever .
Figure 22-1. Rocky Mountain spotted fever cases in the United States (1994-1998)
Ehrlichiosis (Anaplasmosis)
ThoughgenerallyanillnessmilderthanRMSF,ehrlichiosishasmanyofthesamesymp-
toms and, like RMSF, is transmitted to humans by ticks. Two varieties of ehrlichiosis are
found in the United States. One has roughly the same distribution as Lyme disease, the
other is concentrated in the South and mid-Atlantic states. Fever, headache, nausea, and
muscle aches begin a week to ten days after a tick bite. One-third of infected individuals
have a rash. The clue to diagnosis is the development of the typical symptoms following a
tick bite in one of the high-risk geographic areas. Low white blood cell and platelet counts
are frequently found on laboratory testing. Doxycycline is the treatment of choice.
Theoriginalname,ehrlichiosis,hasbeenreplacedwithanaplasmosis.Moreinformation
is available at www.cdc.gov/ticks/diseases/ehrlichiosis .
Relapsing Fever (Tick Fever)
Tick fever occurs in mountainous areas of the western and west-central states. It is a
bloodstream infection caused by a spiral bacterium ( Borrelia recurrentis ) transmitted to
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