Summer's still here - spotted fever too

This past month, three people have been hospitalized at Hillel Yaffe for suspected spotted fever. It is a common disease in Hadera and the surrounding area, especially during the summer. In addition to these cases, the Hadera Health Office also received information on several other cases in the community. The information was passed on to the Ministry of Agriculture and the District Veterinarian so that the animals could be treated and pesticides sprayed in the affected areas. Note that all of the patients hospitalized at Hillel Yaffe were treated and discharged in good health, and that patients with spotted fever are treated at the hospital all year long. 

 "Spotted fever is common in Israel, especially in two areas: the northern Sharon region - meaning Hadera and the surrounding areas, and the Negev," said Dr. Sharon Reisfeld, Senior Physician in the Infectious Diseases Department at Hillel Yaffe Medical Center. "In the summer, the disease is more common, because of the weather and our tendency to spend more time outdoors, in nature, on the grass and other places, where the ticks that spread the disease are found." 

What is spotted fever and how is it transmitted?

Spotted fever is the name of a group of diseases caused by Rickettsia bacteria, which is transmitted from a dog carrying the bacteria to the tick, and from the tick, to humans. As opposed to humans, who contract the disease as soon as they are bitten, dogs generally only carry the disease. "It's important to emphasize," said Dr. Reisfeld, "The disease is not transmitted from patient to patient, unless a tick climbs on to the patient. In other words, people do not transmit the disease to each other. Furthermore, patients have frequently not come into contact with dogs and never noticed a tick bite. You can also become infected from relatively short contact with the tick, for example, after being outside in a grassy area where there are dogs."

Diagnosis of the disease through blood tests is sometimes too late, as they are based on an increase in antibodies for the disease. The disease is treated based on existence of typical symptoms and clinical suspicion. Doctors do not wait for a laboratory diagnosis.

What are the signs of spotted fever?

"The disease can manifest itself in a number of ways," said Dr. Reisfeld. "Sometimes it's a mild disease, which in some cases even goes away by itself without specific antibiotic treatment. In other cases, the disease is more serious, leading the patient to seek medical care from their general practitioner or to be hospitalized. In rare cases, there may be serious complications, which can lead to death in 2%-4% of cases."

The main symptoms are high fever, severe headache, general fatigue and pain throughout the entire body. Three to five days after those symptoms appear, most patients will develop a typical rash. The spots, which give the disease its name, are small, irregularly shaped, light red blotches that generally develop on the extremities and face, and can appear anywhere on the skin. The disease typically affects the soles of your feet and palms. The rash lasts six or seven days and may change during the course of the disease. It may develop a darker bleeding component (like tiny bruises). In some cases, if the patient goes undiagnosed and the disease is not treated with the appropriate course of antibiotics, the patient's condition may deteriorate and result in neurological complications, pneumonia, kidney and liver dysfunction, problems with clotting and the circulatory system, inflammation of the myocardium and in serious cases, even death. The disease is generally mild in children, and the risk of serious disease increases in adults and in people with chronic illnesses.

How can we prevent spotted fever?

As previously mentioned, the disease is most frequent in the summer, in the northern Sharon and Negev regions. In order to avoid tick bites, to the extent possible, take a number of basic steps around your and your dog's environment:

• It is very important to heighten awareness of getting proper veterinary care of your dog.
• It is advisable to treat and dust in and around the doghouse and where the dog likes to be.
• If you have a lawn, be sure to treat it with the appropriate substances.
• Pay close attention to personal hygiene after trips to rural areas or to dog kennels. Additionally, when dealing with babies and children, who may not notice they have a tick on their bodies, check hidden areas on the body such as behind their ears and in the groin area. 

And what if you find a tick on your body?

"If you find a tick, make sure to remove it in its entirety, using a tweezers and not to squish it with your fingers while it is on your body," said Dr. Reisfeld. "It is very important to remove the entire tick, because if parts of it remain, so does the bacteria. After removing the tick, wash all clothes well. Make sure to watch out for any of the physical symptoms mentioned above. If they appear, go get diagnosed and get appropriate medical care."