An infectious diseases consultant recommended treatment for possible TBRF
, and oral doxycycline (100 mg 2x/d) for 14 days was prescribed.
Around the world, different species of Borrelia are recognized as etiological agents of TBRF
, and their epidemiology is directly related to the geographical distribution of their competent vectors (1).
burgdorferi, and, for TBRF
Borrelia, only two serological tests, an IFA test for B.
Isolated cases or small clusters of TBRF
are possible during military field training exercises in endemic regions of the country, most notably Florida, Texas, and the Pacific West.
Prior to this outbreak, the last outbreak of TBRF
in Coconino County occurred in August 2009 in a cabin located about 19 miles north of Flagstaff in the national forest.
Consistent with the Arizona Department of Health Services case definition, a probable case was defined as an illness with at least three of the four major TBRF
signs and symptoms (fever, chills, myalgias, and headache) without laboratory testing in a person attending the camp during August 1-3, 2014.
The numbers of TBRF
cases recorded in successive years during 2000 to 2004 (Figs.
is transmitted by the soft tick of the genus Omithodoros and occurs in Africa, Spain, Saudi Arabia, Asia, and certain areas in the western United States and Canada (it is endemic in the higher elevations and coniferous forests of the western United States and southern British Columbia).
recurrentis is the cause of LBRF, which occurs mainly in the Horn of Africa, several Borrelia species may cause TBRF
, which is found in many areas of the world.
is not nationally reportable, and there is no standard case definition.
Serum samples collected at admission and 3 weeks later ([approximately equal to]5 and 26 days after illness onset, S1 and S2, respectively) were tested in parallel at the Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases, Division of Vector-Borne Infectious Diseases (Fort Collins, CO, USA) by enzyme immunoassay and Western blot (IgM and IgG) for TBRF
A review of the peripheral blood smear to evaluate the newborn's thrombocytopenia incidentally revealed spirochetes consistent with TBRF