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What is Rocky Mountain Spotted Fever (RMSF)? Rocky Mountain spotted fever (RMSF) is a disease caused by the bacteria (germ) Rickettsia rickettsii. Where do cases of RMSF occur? RMSF is a rare disease in Massachusetts. Between 1995-2005, six cases were reported. The disease is most often reported from the southeastern part of the state, Cape Cod and Martha's Vineyard. How is RMSF spread? In the Northeast, RMSF is spread by the bite of an infected dog tick, also called the eastern wood tick. The longer a tick remains attached and feeding, the higher the likelihood that it may spread the bacteria. However, unlike for other tickborne diseases, the germ that causes RMSF often spreads within 24 hours of the tick attaching. How soon do symptoms of RMSF appear after a tick bite? Symptoms usually start to appear about 7 days after the bite of an infected tick, but can begin anywhere between 3 and 14 days.