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Tick-Borne Relapsing Fever in the White Mountains, Arizona, USA, 2013-2018

Neema Mafi, Hayley D Yaglom, Craig Levy

    Emerging Infectious Diseases
    |March 19, 2019
    PubMed

    Insights

    Tick-borne relapsing fever (TBRF) is a bacterial illness transmitted by ticks. Six cases in Arizona

    Area of Science:

    • Infectious Diseases
    • Bacteriology
    • Epidemiology

    Background:

    • Tick-borne relapsing fever (TBRF) is a zoonotic infection caused by Borrelia species.
    • TBRF is transmitted by soft ticks and occurs globally, including the western United States.

    Observation:

    • Six cases of TBRF acquired in the White Mountains of Arizona between 2013-2018 were identified.
    • Clinical presentations included recurrent fever, leukopenia, thrombocytopenia, hyperbilirubinemia, elevated aminotransaminases, and uveitis.
    • Diagnosis was delayed in five cases, with all patients responding to doxycycline therapy.

    Findings:

    • The White Mountains of Arizona, previously not considered a high-incidence area, are implicated in TBRF transmission.
    • The six reported cases suggest potential underdiagnosis of TBRF in this region.
    • Jarisch-Herxheimer reactions occurred in two patients following treatment.

    Implications:

    • Clinicians should consider TBRF in individuals with relevant exposure history in the White Mountains, Arizona.
    • Increased awareness and diagnostic vigilance for TBRF are warranted in this region.
    • Prompt diagnosis and treatment with doxycycline are effective for TBRF management.
    Keywords:
    ArizonaBorrelia hermsiiTBRFUnited StatesWhite Mountainsbacteriabacterial infectionspublic healthrelapsing fevertick-borne relapsing fevertickborne diseasesticksvector-borne infectionszoonoses

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