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Rocky Mountain spotted fever (RMSF) is a tick-borne disease which is caused by an organism Rickettsia rickettsii. Although RMSF can be lethal, it is curable. RMSF is the most common rickettsial infection. The organism is endemic in parts of North, Central, and South America, especially in the southeastern and south-central United States. Rocky Mountain spotted fever (RMSF) is a bacterial disease spread by ticks It typically begins with a fever and headache, and a few days later followed by with the development of a rashes. The rash is generally made up of a 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 loss of hearing or loss of part of an arm or leg. The disease is caused by Rickettsia ricketsii, a type of bacteria that is primarily spread to humans by American dog ticks, Rocky Mountain wood ticks, and brown dog ticks. Rarely the disease is spread by blood transfusions 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. Rocky Mountain spotted fever was first identified in the 1800s in the Rocky Mountains.