Bullis fever: a vanished infection of unknown etiology

Camp Bullis, Texas, is an active training facility for the U.S. Army and Air Force with a storied history dating back to the late 19th century. In the early 1940s, an epidemic of a seasonal tick-borne rickettsial-like illness occurred at Camp Bullis; the last case was reported in 1947. To date, the etiology of this disease has remained elusive. In an attempt to retrospectively identify the causal pathogen, we surveyed Camp Bullis for the presumed tick vector with intent to screen molecularly for Rickettsia and Ehrlichia. However, no ticks were recovered from primary dragging attempts in the spring or from harvested deer in the fall. Moreover, pathologic and microbiologic materials obtained during the epidemic are no longer extant, making them unavailable for analysis. In this study, we review potential circumstances that impact emerging and, in this case, vanishing infections. The etiology of Bullis fever will probably remain undetermined, and this once-emerging infection may have vanished into history. However, given Camp Bullis' status as an active medical training site, awareness of and surveillance for the disease should continue.