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Case Reports
. 2016 May 17:16:210.
doi: 10.1186/s12879-016-1541-z.

Louse-borne relapsing fever - report of four cases in Switzerland, June-December 2015

Michael Osthoff  1 , Adrian Schibli  2 , Davide Fadini  3 , Pietro Lardelli  4 , Daniel Goldenberger  5
Affiliations
Case Reports

Louse-borne relapsing fever - report of four cases in Switzerland, June-December 2015

Michael Osthoff et al. BMC Infect Dis. .

Abstract

Background: Louse-borne relapsing fever (LBRF) is a neglected disease that has been restricted to East Africa for many decades. Several cases in refugees from the Horn of Africa have been recently diagnosed in four European countries.

Case presentation: We report four additional cases of LBRF in asylum seekers from Somalia and Eritrea who presented with fever shortly after arriving in Switzerland during a seven-month period. Multiple spirochetes were visualized on stained blood films which were identified as Borrelia recurrentis by 16S rRNA gene sequencing. All patients recovered after antibiotic treatment with ceftriaxone and/or doxycycline. Concurrent infections (malaria and tuberculosis) were diagnosed in half of our patients. Possible modes of transmission and preventive measures are discussed.

Conclusions: These reported cases highlight the ongoing transmission of LBRF in migrants from East Africa. Diagnosis of LBRF cases and prevention of autochthonous transmission in asylum seeker camps are important steps for the near future.

Keywords: Borrelia recurrentis; Broad-range bacterial PCR; Emerging diseases; Migrants; Relapsing fever.

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Figures

Fig. 1
Fig. 1
Microscopic detection of spirochetes (black arrows) in blood from patient 2. May-Grünwald Giemsa (MGG)-stained blood smear, 1000-fold magnification
See this image and copyright information in PMC

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