Tickborne Relapsing Fever: Epidemiology

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The page below is a sample from the LabCE course Tickborne Diseases. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Tickborne Relapsing Fever: Epidemiology

Tickborne Relapsing Fever (TBRF) is also known as soft tick relapsing fever (STRF). It is caused by several species of Borrelia carried in ticks. B. hermsii is the most common cause of TBRF in the United States (U.S.). B. hermsii is transmitted by the soft tick, Ornithodoros hermsi. B. parkerii and B. turicatae can also cause relapsing fever in the U.S.
Transmission occurs through a brief nighttime feed of fewer than 30 minutes, and the tick bite is painless. Most people are unaware they have been bitten. Many patients who are infected report an overnight stay in rodent-infected dwellings at greater than 2,000 feet elevation. O. hermsi prefers coniferous forests at altitudes of 1,500 to 8,000 feet altitude. These ticks do not search for prey in tall grasses or brush but live in rodent burrows or cabins. The ticks normally feed on tree squirrels and chipmunks.
Most cases occur in summer when vacationers sleep in rodent-infested cabins. TBRF can also occur in winter when fires warm cabins sufficiently to activate the ticks. 70% of all reported TBRF cases are in California (33%), Washington (25%), and Colorado (11%).
Another species, O. turicata, is found at lower altitudes in the Southwest U.S. Cattle, rodents, pigs, snakes, tortoises, and possibly coyotes are hosts for this tick.
Figure 36. Centers for Disease Control and Prevention. (n.d.). Under a magnification of 6.5X, this image depicts a dorsal view of a soft tick, Ornithodoros hermsi, a known vector for the disease tick-borne relapsing fever (TBRF), which is a bacterial infection characterized by recurring episodes of fever, headache, muscle and joint aches, and nausea. It is caused by certain species of Borrelia spirochetes. [Image]. https://phil.cdc.gov/Details.aspx?pid=14477.
Figure 37. Centers for Disease Control and Prevention. (2024). Cases of STRF from 2012 through 2021. [Image]. https://www.cdc.gov/relapsing-fever/about/about-strf.html.

Figure 36. Ornithodoros hermsi tick vector for
Tickborne Relapsing Fever
Figure 37. Cases of Tickborne Relapsing Fever from 2012-2021