Relapsing Fever

Relapsing Fever is an illness caused by the bacteria borrelia recurrentis; characterized by periods of alternating fever and normal temperatures and is spread through the bite of louse or ticks. These alternating episodes can occur up to a dozen times over a period of weeks to months.

Where does it occur?

Tick-borne disease: Africa, Saudi Arabia, Iran, India, North and South Americas

Louse-borne disease: Asia, East Africa, and South America

How is it transmitted?

It is transmitted through the bite of an infected human body louse or soft ticks that are seen on rodents (rats, rabbits, chipmunks, squirrels, mice etc).

Is it contagious from person to person?

It is not directly contagious from person to person, but can be indirectly spread through body lice that goes from an infected person to another.

What is the risk for travelers?

The risk for most travelers is generally low, however maybe higher for those staying in primitive crowded dwellings or engaged in outdoor activities where exposure to louse and ticks are likely.

How soon after exposure will one develop symptoms?

Symptoms can develop 4 days to 2 weeks after exposure; it is usually seen within a week.

What are the signs and symptoms?

Symptoms are of a high fever (102-105 degree F) with chills, shakes, body aches, joint pains and cough that lasts 2-7 days followed by a period of normal temperature for 4-7 days. During the fever phase one may see small, red pin size rash. One may also experience cough with blood streaks, bleeding from the nose or blood in the urine or feces. Central nervous system involvement with meningitis and seizures or paralysis can also be seen.

The fevers can end suddenly with significant sweats and even shock.

Characteristically after a period of 4-7 days the fever and associated symptoms suddenly reappear, thus its name relapsing fever.

Tick borne relapsing fever is associated with numerous relapses and higher temperatures, while louse borne relapsing fever might only relapse once.

Are there any lab tests to diagnose the illness?

Thick and thin blood smears may demonstrate the bacteria under microscopic examination.

Is there any treatment?

Doxycycline is the treatment of choice.

What preventive measures can be taken?

Following the insect safety guidelines and staying indoors and in non-primitive, uncrowded accommodations are the best preventive measures.

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