Rocky Mountain Spotted Fever: A Neglected Threat in the Americas

Rocky Mountain Spotted Fever (RMSF), one of the deadliest infectious diseases, is increasingly spreading across the Americas due to insufficient awareness, research, and resources. Experts at the American Society of Tropical Medicine & Hygiene’s 2024 annual meeting highlighted the urgent need to address this bacterial disease, which can lead to fatalities within days if untreated.

A Growing Threat

RMSF, caused by the bacterium Rickettsia rickettsii and transmitted by ticks, presents a rapid progression from vague symptoms like fever and headache to severe outcomes, including organ failure and death. The disease is marked by a rash of red spots that typically appears three to four days after the onset of symptoms. Without early treatment using the antibiotic doxycycline, the case fatality rate (CFR) can reach as high as 50% in some regions, such as São Paulo, Brazil.

In northern Mexico, RMSF has become a severe public health crisis, disproportionately impacting impoverished communities. Over the past 15 years, nearly 10,000 cases have been documented there, with outbreaks fueled by uncontrolled tick populations and stray dogs.

Why the High Fatality Rates?

Delayed diagnosis due to RMSF’s nonspecific early symptoms is a critical factor. In many cases, patients die within a week of symptom onset. Survivors may face lifelong consequences, such as cognitive impairments and amputations caused by gangrene.

Calls to Action

Experts, including Gerardo Álvarez-Hernández of the University of Sonora, emphasize that combating RMSF requires:

1. Enhanced Surveillance: More comprehensive data collection and monitoring to track outbreaks.
2. Community Education: Raising awareness about RMSF symptoms and prevention in at-risk areas.
3. Physician Training: Equipping healthcare providers with the knowledge to diagnose and treat RMSF promptly.
4. Improved Diagnostics: Developing better tools for early and accurate identification.
5. Official Recognition: Designating RMSF as a neglected tropical disease to attract funding and political support.

The Path Forward

Addressing RMSF requires not only scientific and medical efforts but also significant political commitment and resources. Álvarez-Hernández stresses the urgency of coordinated action to prevent further loss of life.

“We need political will, resources, budgets, and scientific effort,” he said. “It’s time to stop neglecting this deadly disease.”

With increased awareness and targeted interventions, RMSF could be controlled and its devastating toll on vulnerable populations significantly reduced.