In the eastern United States, children are infected most frequently, while in the western United States, disease incidence is highest among adult males. Disease incidence is directly related to the exposure to tick-infested habitats or to infested pets. Most of the cases in New York State have occurred on Long Island. Person to person spread of RMSF does not occur. The rash begins on the legs or arms, may include the soles of the feet or palms of the hands and may spread rapidly to the trunk or rest of the body.
Symptoms usually appear within two weeks of the bite of an infected tick.
One attack probably provides permanent immunity. Certain antibiotics such as tetracycline or chloramphenicol may be effective in treating the disease. Frequent checking of clothing and skin when in infested areas is extremely useful in reducing potential incidence of disease. Tick repellents applied to legs and clothing may be helpful to prevent tick attachment. If tweezers are not available, use fingers shielded with tissue paper or rubber gloves.