Relapsing fever epidemiology and demographics
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
LBRF is an epidemic disease with a history from Hippocrates' times, whereas TBRF is endemic causing sporadic cases since it depends on the presence of tick reservoirs. TBRF is endemic in the western US, southern British Columbia, plateau regions of Mexico, Central and South America, the Mediterranean, Central Asia, and much of Africa. In the United States, TBRF usually occurs west of the Mississippi River, particularly in the mountainous West and the high deserts and plains of the Southwest. In the mountains of California, Utah, Arizona, New Mexico, Colorado, Oregon, Washington, infections are usually caused by Borrelia hermsii and are often acquired in cabins in forests.LBRF is mainly a disease of the developing world. It is currently seen in Ethiopia and Sudan. It is currently seen in Ethiopia and Sudan. Famine, war, overcrowding, and the movement of refugee groups often results in LBRF epidemics.
Epidemiology and Demographics
Case-fatality rate/Mortality rate
- With antibiotic treatment, the mortality of epidemic relapsing fever decreases from 10% to 40% to 2% to 4%.
- Fatalities are lower in tick-borne disease compared to louse-borne disease, with treatment.[1]
Region
- TBRF is endemic in the western US, southern British Columbia, plateau regions of Mexico, Central and South America, the Mediterranean, Central Asia, and Africa.
- The first endemic region of TBRF in the US was identified in 1915 in Colorado (Meader 1915) though the first case was actually in 1905 in New York in a traveler to Texas. Since then, TBRF has been reported in 14 states: Arizona, California, Colorado, Idaho, Kansas, Montana, Nevada, New Mexico, Ohio, Oklahoma, Oregon, Texas, Utah, Washington, and Wyoming.
- Most recent cases and outbreaks have occurred in rustic cabin or vacation home settings at higher elevations (> 8,000 feet) in coniferous forests in the western US.
TBRF occurs typically in summer months when people are traveling to mountainous areas on vacation. TBRF can occur in winter, mainly when people go into rodent-infested cabins and start fires, warming the place and producing carbon dioxide and warmth that attract the ticks that transmit TBRF.
Developed Countries
- TBRF is reported worldwide, except Antarctica, Australia, and the Pacific Southwest.
Although TBRF was removed from the list of nationally notifiable conditions in 1987, 11 states require TBRF to be reported to their State Health Departments (Arizona, California, Colorado, Idaho, Nevada, New Mexico, Oregon, Texas, Utah, Washington, and Wyoming). Other states, such as Montana, may institute reporting in the future. [2]. Most cases of endemic relapsing fever occur in the late spring and summer.
Devloping countries:
LBRF is mainly a disease of the developing world. It is currently seen in Ethiopia and Sudan. Famine, war, and the movement and groups of refugees often result in epidemics of LBRF. The largest recent epidemics of LBRF occurred during World Wars I and II. At least 1 million people died during these epidemics.[3] it is currently prevalent in Ethiopia and Sudan.
References
- ↑ Kolarík J (1971). "Different reaction of focal and diffuse epileptic EEG activity to psilocybin". Act Nerv Super (Praha). 13 (3): 215–6. PMID 5000337.
- ↑ http://www.cdc.gov/ncidod/dvbid/RelapsingFever/RF_Epidemiology.htm
- ↑ Cutler S (2006). "Possibilities for relapsing fever reemergence". Emerg Infect Dis. 12 (3): 369–74. PMID 16704771.