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==History== Rocky Mountain spotted fever (or "black measles" because of its characteristic rash) was recognized in the early 1800s, and in the last 10 years of the 1800s (1890β1900) it became very common, especially in the Bitterroot Valley of Montana. The disease was originally noted to be concentrated on the west side of the Bitterroot river.<ref>{{Cite web|url=https://www.niaid.nih.gov/about/rocky-mountain-history|title=History of Rocky Mountain Labs (RML) {{!}} NIH: National Institute of Allergy and Infectious Diseases|website=www.niaid.nih.gov|access-date=2019-01-18}}</ref> Though it would be decades before scientists discovered the tick as the carrier of the disease, in as early as 1866, Dr. John B. Buker (establishing a practice in Missoula, MT) noticed a tick embedded in the skin of one of his patients. His notes were later studied as part of later research.<ref>Bleed, Blister and Purge: A History of Medicine on the American Frontier by Volney Steele, M.D.{{ISBN|0-87842-505-5}}</ref> In 1901, Dr. A. F. Longeway was appointed to solve "the black measles problem" in Montana. He in turn enlisted his friend Dr. Earl Strain to help him. Strain suspected that the illness was from ticks. In 1906, [[Howard T. Ricketts]], a pathologist recruited from the University of Chicago, was the first to establish the identity of the infectious organism (the organism smaller than a bacterium and larger than a virus) that causes this disease. He and others characterized the basic [[epidemiology|epidemiological]] features of the disease, including the role of tick vectors. Their studies found that Rocky Mountain spotted fever is caused by ''Rickettsia rickettsii'', named in Ricketts's honor. Ricketts died of [[typhus (disease)|typhus]] (another rickettsial disease) in [[Mexico]] in 1910, shortly after completing his studies on Rocky Mountain spotted fever.{{citation needed|date=January 2023}} Prior to 1922, Doctors McCray and McClintic both died while doing research on Rocky Mountain spotted fever, as did an aide of [[Noguchi Hideyo]] at the Rockefeller Institute.{{citation needed|date=January 2023}} Research began in 1922 in western Montana, in the [[Bitterroot Valley]] around [[Hamilton, Montana]], after the Governor's daughter and his son-in-law died of the fever. However, prior to that, in 1917, Dr. Lumford Fricks introduced herds of sheep into the Bitterroot Valley. His hypothesis was that the sheep would eat the tall grasses where ticks lived and bred.<ref>Steele, Volney, M.D. Bleed, Blister and Purge: A History of Medicine on the American Frontier. Mountain Press Publishing Company, Missoula, Montana. 2005.</ref> Past Assistant Surgeon R.R. Spencer of the Hygienic Laboratory of the [[U.S. Public Health Service]] was ordered to the region, and he led a research team at an abandoned schoolhouse through about 1924.<ref>{{cite book |author1=Spencer R.R. |author2=Parker R.R. |title=Studies on Rocky Mountain spotted fever |publisher=U.S. G.P.O. |location=Washington |year=1930 |oclc=16141346 |series=Hygienic Laboratory Bulletin |volume=154 |url=https://books.google.com/books?id=6C9DAAAAYAAJ}}<br /></ref><ref name="de_Kruif_1932">{{cite book |author=de Kruif, Paul |author-link=Paul de Kruif |chapter=Ch. 4 Spencer: In the Happy Valley |title=Men Against Death |publisher=Harcourt, Brace |location=New York |year=1932 |oclc=11210642 |chapter-url=https://books.google.com/books?id=IokwAAAAIAAJ&q=editions:IokwAAAAIAAJ}}</ref> Spencer was assisted by R. R. Parker, Bill Gettinger, Henry Cowan, Henry Greenup, Elmer Greenup, Gene Hughes, Salsbury, Kerlee, and others, of whom Gettinger, Cowan and Kerlee died of Rocky Mountain spotted fever.<ref name="de_Kruif_1932"/> Through a series of discoveries, the team found that a previous blood meal was necessary to make the tick deadly to its hosts, as well as other facets of the disease.<ref name="de_Kruif_1932"/> On May 19, 1924, Spencer put a large dose of mashed wood ticks, from lot 2351B, and some weak [[carbolic acid]] into his arm by injection. This [[vaccine]] worked, and for some years after it was used by people in that region to convert the illness from one with high fatality rate (albeit low incidence) to one that could be either prevented entirely (for many of them) or modified to a non-deadly form (for the rest).<ref name="de_Kruif_1932"/> Today there is no commercially available vaccine for RMSF<ref name="cdc"/> because, unlike in the 1920s when Spencer and colleagues developed one, antibiotics are now available to treat the disease, so prevention by vaccination is no longer the sole defense against likely death.{{citation needed|date=January 2023}} Much of the early research was conducted at [[Rocky Mountain Laboratories]],<ref>{{cite web |url=http://www3.niaid.nih.gov/about/organization/dir/rml/ |title=Rocky Mountain Laboratories Official Site |access-date=2009-06-24}}</ref><ref>{{cite web |url=https://www.cdc.gov/ncidod/dvrd/rmsf/overview.htm |title=Overview |work=Rocky Mountain Spotted Fever |publisher=Centers for Disease Control |date=2018-10-26 }}</ref> a part of the [[National Institute of Allergy and Infectious Diseases]]. The schoolhouse laboratory of 1922β1924, filled with ticks in various phases of the life cycle, is identified in retrospect as a [[biological hazard|biohazard]], although the team did not fully appreciate it at first. The deaths of Gettinger and Cowan, and the near death of the janitor's son, were the results of inadequate [[biocontainment]], but in the 1920s, the elaborate biocontainment systems of today had not been invented.
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