Another reason why personal hygiene should include the regular removal of lice..

Relapsing fever is a group of quite similar diseases caused by spiral bacteriae of the genus Borrelia (causing Lyme disease with Borrelia Burgdorferi) transmitted by a number of different vectors. The most common borrelia around the western world is Borrelia recurrentis, while in Africa Borrelia duttoni is being transmitted by Ticks.

The most important human parasite transmitting relapsing fever is the human body louse Pediculus humanus which transmits the bacteria after biting its host. The louse and the bacteria it carries are pretty ubiquitous and can appear everywhere where people live in squalour or lacking personal hygiene.

The symptoms of relapsing fever are initially quite unspecific,but while the Borrelias are present, the patients suffer fever, headaches, malaise and muscleaches that last beween 4 - 7 days. The fever will then spontaneously go into remission, just to reappear after three to six days later. On closer examination myocarditis, meningoencephlitis and hepatosplenomegaly can be present, and hepatorenal failure can be a complication.

Diagnosis is made by finding the organisms in a Romanowsky stained thick blood film while the patient is symptomatic (a nice picture can be found here: .

Treatment is with Tetracycline, but the healthcare professional should look out for the dreaded Herxheimer Reaction and anticipate problems.

As ever prevention is better than treatment, so mass delousing programs, improved personal hygiene and getting people off the street are the best methods to stop this disease from spreading.

Source: Dion. R. Bell, Tropical Medicine, 4th edition, Blackwell Science, 2000

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