Updated

A 61-year-old North Carolina woman who died earlier this year was among the rare fatal cases of Rocky Mountain spotted fever, a tick-borne disease that hits North Carolina and Oklahoma harder than any other state, health officials said today.

The Guilford County woman died in May and her diagnosis was recently confirmed by the Centers for Disease Control and Prevention, which lists the fever as the most severe and most frequently reported rickettsial illness in the country.

The last fatal case of spotted fever was reported in 2005. There were 862 cases in 2006, and 261 cases have been reported so far this year, state health officials said in a written statement.

"This is a serious illness, but it can be largely prevented by limiting exposure to tick bites," said Dr. Jeffrey Engel, the state epidemiologist. "North Carolina and Oklahoma account for the most cases of Rocky Mountain spotted fever in the country, so we need to be particularly vigilant here."

Limiting exposure includes using tick repellents, wearing light colored clothing so ticks can be spotted, and tucking pants into socks to prevent ticks from biting legs, officials said.

Symptoms include rash, headache and muscle pain, according to the CDC. Officials also recommended a body check after being in areas possibly infested with ticks.