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Edited article: Relapsing fever

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History[edit | edit source]
Relapsing fever has been described since the days of the ancient Greeks.[9] After an outbreak in Edinburgh in the 1840's, relapsing fever was given its name, but it would not be another decade until the etiology of the disease would be better understood.[10] The physician David Livingstone is credited with the first account in 1857 of a malady associated with the bite of soft ticks in Angola and Mozambique.[11] In 1873, Otto Obermeier first described the disease-causing ability and mechanisms of spirochete, but was unable to reproduce the disease in inoculated test subjects and thereby unable to fulfill Koch's postulates.[12] It would not be until 1874 that the disease was successfully produced in an inoculated subject.[13] In 1904 and 1905, a series of papers outlined the cause of relapsing fever and its relationship with ticks.[14][15][16][17] Both Joseph Everett Dutton and John Lancelot Todd contracted relapsing fever by performing autopsies while working in the eastern region of the Congo Free State. Dutton died there on February 27, 1905. The cause of tick-borne relapsing fever across central Africa was named Spirillum duttoni.[18] In 1984, it was renamed Borrelia duttoni.[19] The first time relapsing fever was described in North America was in 1915 in Jefferson County, Colorado.[20]

Sir William MacArthur suggested that relapsing fever was the cause of the yellow plague, variously called pestis flava, pestis ictericia, buidhe chonaill, or cron chonnaill, which struck early Medieval Britain and Ireland, and of epidemics which struck modern Ireland in the famine.[21][22]

Treatment[edit | edit source]
Relapsing fever is easily treated with a one- to two-week-course of antibiotics, and most people improve within 24 hours. Complications and death due to relapsing fever are rare.

Tetracycline-class antibiotics are most effective. These can, however, induce a Jarisch–Herxheimer reaction in over half those treated, producing anxiety, diaphoresis, fever, tachycardia and tachypnea with an initial pressor response followed rapidly by hypotension. Recent studies have shown tumor necrosis factor-alpha may be partly responsible for this reaction.

Research has shown that patients exposed to tick-borne relapsing fever can be successfully treated with doxycycline.[8]