Relapsing fever borreliosis

Relapsing Fever Borreliosis is an infectious disease caused by certain types of bacteria belonging to the genus Borrelia. It is characterized by recurrent episodes of fever, often accompanied by headache, muscle and joint aches, and nausea. This condition is transmitted to humans through the bite of infected ticks or, less commonly, through contact with infected human body fluids or lice. The disease is known for its distinctive pattern of fever that recedes and then returns, making it a challenging condition to diagnose and treat effectively.

Etiology

Relapsing fever borreliosis is caused by several species of Borrelia bacteria. The two main types of relapsing fever are Tick-Borne Relapsing Fever (TBRF) and Louse-Borne Relapsing Fever (LBRF). TBRF is transmitted by the bite of infected Ornithodoros ticks, which tend to feed and detach quickly, often going unnoticed by the host. LBRF is caused by Borrelia recurrentis, which is spread through the human body louse Pediculus humanus corporis. Unlike TBRF, LBRF can lead to epidemics under conditions of overcrowding and poor hygiene.

Clinical Features

The clinical presentation of relapsing fever borreliosis includes sudden onset of high fever, chills, headache, muscle and joint pains, and nausea. The fever episodes last for several days, followed by periods of recovery, with this cycle repeating several times. Complications can include hepatomegaly, splenomegaly, meningitis, and myocarditis. The diagnosis is often made based on clinical symptoms and confirmed through microscopic examination of blood smears, serological tests, or PCR to detect Borrelia DNA.

Treatment

The treatment of relapsing fever borreliosis typically involves antibiotics such as doxycycline, erythromycin, or penicillin. Early treatment is crucial to prevent complications and reduce the risk of chronic symptoms. In cases of LBRF, addressing the conditions that lead to louse infestation is also an important component of controlling the disease.

Prevention

Preventive measures for relapsing fever borreliosis focus on avoiding tick bites and improving living conditions to prevent louse infestations. This includes using insect repellent, wearing protective clothing, and ensuring cleanliness and adequate personal hygiene. In areas where TBRF is endemic, reducing rodent populations can also help minimize the risk of tick bites.

Epidemiology

Relapsing fever borreliosis has a worldwide distribution, with TBRF occurring in both the Old and New Worlds, often in rural or mountainous areas. LBRF is more closely associated with conditions of poverty, war, and displacement and has been responsible for large outbreaks in the past, particularly in Africa and Asia.