Cases are on the rise, health officials say, but knowing the signs and how the illness is contracted can help you stay safe.

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It's a heartbreaking story: an Indiana girl just shy of her third birthday has died of organ failure caused by Rocky Mountain Spotted Fever (RMSF). Doctors didn’t realize Kenley Ratliff contracted the tick-borne illness until it was too late for the antibiotics to work.

Now, her devastated family, along with health officials, are sounding the alarm about this sometimes lethal infection, which despite its name isn't limited to the Rocky Mountains. “If we could save one child’s life then we will have done our job,” Jordan Clapp, Kenley’s aunt told Today.

While you dry your eyes, consider Kenley's story to be a wakeup call about RMSF, cases of which have been on the rise over the past decade, reports the Centers for Disease Control and Prevention.

When it comes to tick-transmitted illnesses, Lyme disease is the one that gets the media spotlight. But lesser-known RMSF is actually more serious. “The issue with Rocky Mountain Spotted Fever is, unlike many other tick-borne diseases, it’s more severe and can cause death,” says Colleen Nash, MD, MPH, a pediatric infectious diseases specialist at Rush University Medical Center in Chicago.

What is Rocky Mountain Spotted Fever?

Different species of ticks can pass along different diseases. In the case of RMSF, the infection agents are the American dog tick, the Rocky Mountain wood tick, and the brown dog tick. All three can transmit the bacteria Rickettsia rickettsii to a human adult or child through a bite. (The tick must be attached for several hours to pass along this bacteria.)

The problem is, half of all people infected with the disease have no idea that they were bitten by a tick in the first place. Ticks are incredibly small, and you may not be on the lookout for them. Making things worse, “symptoms are similar to a lot of other basic and benign infections and illnesses, like fever, headache, and vomiting and diarrhea," says Dr. Nash. "It can be difficult to identify in both children and adults." And even though cases are increasing, RMSF is still rare, she says, so it’s not the first thing a doctor may suspect.

In the case of Kenley Ratliff, she was initially taken to the emergency room with a high fever, where she was given antibiotics, according to Today. When she didn't improve, she was diagnosed with strep throat and given more antibiotics. When she still wasn't better, her family took her to a different hospital. At that time, she had begun to develop a telltale rash on her arms and legs, which signaled that it could be RMSF. Sadly, she was also developing organ failure and brain swelling.

The rash, which is where "spotted" comes from in the disease's name, typically appears two to five days after a fever begins. It starts near the wrists and the ankles and then moves upward to the trunk. The spots are often small, flat, and pink, but they don’t itch. Still, not having a rash isn't necessarily a sign of being free of RMSF; 10% of people diagnosed with it don’t get a rash at all.

“If treatment is delayed by five days or more, there patient has a poor prognosis. But often, the rash doesn’t appear until that time,” says Dr. Nash. That doesn’t mean it will be fatal, but you may get severely ill and have to be hospitalized.

How to stay safe

Protect yourself and your family by checking each other for ticks (don’t forget in your hair!) when you come in from playing outside. Give your dog a once-over, too, and make sure all pets in your household are up-to-date on any flea and tick medication. Recent research suggests that dogs are one of the major ways humans are exposed to ticks.

If you or a loved one comes down with an unexplained or severe illness, especially in late spring and summer (when we’re not in the thick of cold and flu season), give your doctor as much info about your recent whereabouts and outdoor habits as possible, suggests Dr. Nash. Tell them if you’ve been camping or even just out in your yard. Talk about any recent travel, including where you’ve been and if you explored a new city or did a lot of outdoor activities.

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That goes double if you noticed ticks in the area, especially if you got a bite and the tick looked engorged. If a tick appears, remove it, put it in a plastic bag, and take it to your doctor, who can have it tested and identified, says Dr. Nash. (Here’s a handy how-to video for tick removal.)

Depending on the species of tick and potential disease it can carry, you might be put on a preventative round of antibiotics (as in Lyme) or watched carefully for symptoms over 7 to 10 days, as is the protocol for suspected RMSF. Stay on the lookout for signs of infection, including a fever and the telltale rash. Don't wait to see if it gets better on its own; when it comes to RMSF, time is of the essence.