TY - JOUR AU - Domínguez, María Carmen AU - Vergara, Salvador AU - Gómez, María Carmen AU - Roldán, María Esther T1 - Epidemiology of Tick-Borne Relapsing Fever in Endemic Area, Spain T2 - Emerging Infectious Disease journal PY - 2020 VL - 26 IS - 5 SP - 849 SN - 1080-6059 AB - Tick-borne relapsing fever (TBRF) is caused by spirochetes of Borrelia bacteria. We collected data on all TBRF cases in a TBRF-endemic area in southwest Spain during 1994–2016. We analyzed data from 98 patients in whom TBRF was diagnosed by light microscopy and analyzed the relationship between climatic data and TBRF incidence. Most cases occurred a rural environment during summer and autumn. We describe demographic, epidemiologic, clinical, and analytical characteristics, treatment, and occurrence of Jarisch-Herxheimer reaction. Most patients had fever and headache, and laboratory test results included elevated C-reactive protein, thrombocytopenia, and neutrophilia. No patients died, but 10.1% had Jarisch-Herxheimer reaction. B. hispanica was the infecting species in 12 cases with PCR results. Clinicians often do not suspect TBRF because clinical signs and symptoms vary; therefore, it is likely underdiagnosed, even in disease-endemic areas. KW - Borrelia hispanica KW - tickborne relapsing fever KW - endemic borreliosis KW - Jarisch-Herxheimer reaction KW - bacteria KW - arthropodborne disease KW - zoonosis KW - Spain KW - tick-borne relapsing fever KW - zoonoses KW - vector-borne infections DO - 10.3201/eid2605.190745 UR - https://wwwnc.cdc.gov/eid/article/26/5/19-0745_article ER - End of Reference