<unk>  <unk>  is a bacterial disease spread by ticks. It typically begins with a fever and headache, which is followed a few days later with the development of a rash. The rash is generally made up of small spots of bleeding and starts on the wrists and ankles. Other symptoms may include muscle pains and vomiting. Long-term complications following recovery may include hearing loss or loss of part of an arm or leg. The disease is caused by Rickettsia rickettsii, a type of bacterium that is primarily spread to humans by American dog ticks,<unk><unk>  wood ticks, and brown dog ticks. Rarely the disease is spread by blood transfusions. Diagnosis in the early stages is difficult. A number of laboratory tests can confirm the diagnosis but treatment should be begun based on symptoms. It is within a group known as spotted fever rickettsiosis, together with Rickettsia parkeri rickettsiosis, Pacific Coast tick fever, and rickettsialpox. Treatment of<unk>  is with the antibiotic doxycycline. It works best when started early and is recommended in all age groups, as well as during pregnancy. Antibiotics are not recommended for prevention. Approximately 0.5% of people who are infected die as a result. Before the discovery of tetracycline in the 1940s, more than 10% of those with<unk>  died. Fewer than 5,000 cases are reported a year in the United States, most often in June and July. It has been diagnosed throughout the contiguous United States, Western Canada, and parts of Central and South America.<unk>  was first identified in the 1800s in the<unk><unk> s.
Rocky Mountain spotted fever
Zika fever
Flinders Island spotted fever
American tick bite fever
Trench fever
Chikungunya
Japanese spotted fever
Dengue fever