Relapsing Fever

Relapsing fever is an infection caused by bacteria of the genus Borrelia, excluding those responsible for Lyme disease (see this term) belonging to the Borrelia burgdorferi complex.

Epidemiology

Louse-borne relapsing fever is a world-wide disease but occurs mainly in localized regions of developing countries. Tick-borne relapsing fever occurs in Africa, the Mediterranean region, Asia and America. Only a few imported cases are seen in Northern European countries.

Clinical description

The disease is characterized by cyclic fever (alternating periods of sudden fever followed by remission) associated with a general state of ill health with other rare complications (cardiac, neurologic or ocular manifestations and hemorrhage).

Etiology

The disease may be epidemic and transmitted by lice or endemic and transmitted by soft-bodied ticks (Ornithodoros and Argas).

Diagnostic methods

Diagnosis revolves around direct examination of stained blood smears and on PCR analysis of blood samples.

Differential diagnosis

The principle differential diagnosis is malaria.

Management and treatment

Antibiotic treatment (cycline) is effective. Prevention revolves around eradication of the host vector.