Rocky Mountain Spotted Fever (RMSF), caused by Rickettsia rickettsii, is one of the most severe infectious diseases in the Americas.
The pathogen targets endothelial cells, leading to widespread microvascular damage, fluid leakage, and severe complications such as pneumonitis, myocarditis, kidney injury, and meningoencephalitis.
In advanced cases, RMSF can cause respiratory distress, cardiac abnormalities, coma, and peripheral gangrene, with high mortality rates if left untreated.
Timely diagnosis and immediate antibiotic administration are critical, as mortality can reach 50% within the first eight days of illness.
RMSF is transmitted through various tick species, with Rhipicephalus sanguineus (brown dog tick) playing a significant role in Mexico, while Amblyomma species contribute to transmission in Brazil and North America.
The disease is endemic across Canada, the United States, Mexico, and South America, with an increasing number of urban outbreaks linked to poor sanitation, high tick populations, and free-roaming dogs.
A One Health approach has identified three primary ecological zones for RMSF transmission: sylvatic (wildlife-based), peridomestic (domesticated animal involvement), and urban (densely populated regions).
Control efforts require vector management, improved veterinary care, environmental modifications, and public health initiatives.
The brown dog tick presents a particular challenge due to its resistance to acaricides, necessitating integrated pest management strategies, including the use of isoxazolines and environmental barriers.
RMSF remains a serious public health concern, demanding coordinated intervention.
Preventative strategies - such as early recognition, vector control, sterilization programs, and public awareness - are essential to reducing transmission and improving patient outcomes.
Healthcare professionals must remain vigilant in identifying and managing suspected cases to mitigate the disease’s increasing burden.
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References: Foley J., López-Pérez A.M., Álvarez-Hernández G (2025) A Wolf at The Door: The Ecology, Epidemiology & Emergence of Community & Urban-Level Rocky Mountain Spotted Fever in The Americas. American Journal of Veterinary Research 86(3):368-378. https://doi.org/10.2460/ajvr.24.11.0368 Accessed March 10, 2025
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