Symptoms
The first symptoms of RMSF may include
- Moderate to high fever, which can persist for 2 to 3 weeks if the infection is untreated
- Nausea
- Vomiting
- Severe headache
- Deep muscle pain
- Significant tiredness
- Chills
- Lack of appetite
You usually will see the rash 2 to 5 days after the fever begins. The red-spotted rash often starts as small, flat, pink, non-itchy spots on your wrists, forearms, and ankles. These spots turn pale when you apply pressure. They eventually become raised on your skin. In the late stages of the illness, skin tissue begins to die and turn black – thus the original local name “black measles.” A few people with RMSF never develop a rash.
Some people develop additional symptoms later in the disease, including rash on the palms of their hands or soles of their feet, abdominal pain, joint pain, and diarrhea.