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

Authors:
Neema Mafi
Neema Mafi
Mayo Clinic
Craig Levy
Craig Levy
Northeastern University
United States
Anissa Taylor
Anissa Taylor
2 Pima County Health Department
Kenneth K Komatsu
Kenneth K Komatsu
Arizona Department of Health Services
Brentin Roller
Brentin Roller
Banner University Medical Center
Tucson | United States

Emerg Infect Dis 2019 Apr;25(4):649-653

Tick-borne relapsing fever (TBRF) is a bacterial infection transmitted by tick bites that occurs in several different parts of the world, including the western United States. We describe 6 cases of TBRF acquired in the White Mountains of Arizona, USA, and diagnosed during 2013-2018. All but 1 case-patient had recurrent fever, and some had marked laboratory abnormalities, including leukopenia, thrombocytopenia, hyperbilirubinemia, and elevated aminotransaminases. One patient had uveitis. Diagnosis was delayed in 5 of the cases; all case-patients responded to therapy with doxycycline. Two patients had Jarisch-Herxheimer reactions. The White Mountains of Arizona have not been previously considered a region of high incidence for TBRF. These 6 cases likely represent a larger number of cases that might have been undiagnosed. Clinicians should be aware of TBRF in patients who reside, recreate, or travel to this area and especially for those who sleep overnight in cabins there.

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http://dx.doi.org/10.3201/eid2504.181369DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6433026PMC
April 2019
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(Supplied by CrossRef)
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