Everything about Relapsing Fever totally explained
Relapsing fever is an infection caused by certain
bacteria in the genus
Borrelia. It is a
vector-borne disease that's transmitted through louse or soft-bodied tick bites.
Infection
Louse-borne relapsing fever
Borrelia recurrentis is the only agent of louse-borne disease.
Pediculus humanus, is the specific vector. Louse-borne relapsing fever is more severe than the tick-borne variety.
Louse-borne relapsing fever occurs in
epidemics amid poor living conditions, famine and war in the
developing world; it's currently prevalent in
Ethiopia and
Sudan.
Mortality rate is 1% with treatment; 30-70% without treatment. Poor prognostic signs include severe
jaundice, severe change in mental status, severe bleeding, and prolonged
QT interval on
ECG.
Lice that feed on infected humans acquire the
Borrelia organisms that then multiply in the gut of the louse. When an infected louse feeds on an uninfected human, the organism gains access when the victim crushes the louse or scratches the area where the louse is feeding.
B. recurrentis infects the person via mucous membranes and then invades the bloodstream. No animal reservoir exists.
Tick-borne Relapsing Fever
Other relapsing infections are acquired from other
Borrelia species, such as
Borrelia hermsii or
Borrelia parkeri, which can be spread from rodents, and serve as a reservoir for the infection, via a
tick vector.
Borrelia hermsii and
Borrelia recurrentis cause very similar diseases although the disease associated with
Borrelia hermsii has more relapses and is responsible for more fatalities, while the disease caused by
B. recurrentis has longer febrile and afebrile intervals and a longer incubation period.
Tick-borne relapsing fever is found primarily in Africa, Spain, Saudi Arabia, Asia, and certain areas in the Western U.S. and Canada.
Diagnosis
Most people who are infected get sick around 5-15 days after they're bitten by the tick. The symptoms may include a sudden
fever, chills,
headaches, and muscle or joint aches, and
nausea; a rash may also occur. These symptoms continue for 2-9 days, then disappear. This cycle may continue for several weeks if the person isn't treated. Relapsing Fever is easily treated with 1-2 weeks of
antibiotics. Most people improve within 24 hours of starting antibiotics. Complications and death due to relapsing fever are rare.
Relapsing fever is a candidate etiology for a mysterious series of plagues in late medieval and early renaissance-era England referred to at the time as
sweating sickness but which have not recurred in epidemic form since the 16th Century.
Treatment
Antibiotics of the
tetracycline class are most effective, but may induce a
Jarisch-Herxheimer reaction, which occurs in over 50% of patients. This reaction produces apprehension,
diaphoresis, fever,
tachycardia, and
tachypnea with an initial pressor response followed rapidly by
hypotension. Recent studies have shown that
tumor necrosis factor-alpha (TNF-alpha) may be partly responsible for the reaction.
Further Information
Get more info on 'Relapsing Fever'.
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