• Causative organism: members of the genus Borrelia
  • Louse Borne Relapsing Fever (LBRF)
    • Human body louse (Pediculus humanus)
    • Associated with sporadic outbreaks especially in areas with large refugee populations
  • Tick Borne Relapsing Fever (TBRF)
    • Soft ticks of the genus Ornithodoros
    • Typically found in higher elevations of the western United States as well as the central plateau region of Mexico, Central and South America and Africa
• Clinical Presentation
  • Symptoms develop 3 to 18 days after infection.
  • Onset is abrupt and may include fever, malaise, headache, arthralgias, nausea and vomiting and cough.
  • The first febrile episode lasts 3 to 6 days and then recurrences may occur after 7 to 10 days.
• Diagnosis
  • Definitive diagnosis: visualization of spirochetes on peripheral blood smear.
  • May also see leukocytosis, anemia and/or thrombocytopenia, elevation of liver function tests
  • Erythrocyte rosette formation may be present.
• Treatment
  • Antibiotics recommended for treatment include penicillin, doxycycline and erythromycin.
  • Jarisch-Herxheimer reaction common after treatment. This can be life threatening and all patients undergoing treatment should be closely monitored.

University of Maryland Section for Global Emergency Health

Author: Gentry Wilkerson

References

1. Centers for Disease Control and Prevention CDC. Tickborne relapsing fever in a mother and newborn child--Colorado, 2011. MMWR Morb Mortal Wkly Rep. 2012;61(10):174–176.
2. Larsson C, Andersson M, Bergström S. Current issues in relapsing fever. Curr Opin Infect Dis. 2009;22(5):443–449.