Borrelia recurrentis is transmitted by lice and causes classic relapsing fever.
Synonym: louse-borne relapsing fever (LBRF)
Vector: primarily the body louse, also the head louse, Infection can occur when lice are crushed into skin breaks or the person is exposed to louse excrement.
The infection tends to affect people living in conditions of poor hygiene (homeless, poor, migrants, soldiers).
Clinical features:
(1) abrupt onset of high-grade fever
(2) pain
(3) anorexia
(4) dry cough
(5) fatigue
(6) jaundice
Complications:
(1) a hemorrhagic diathesis
(2) neurologic symptoms
(3) splenic rupture
If the person survives the acute episode then there are relapses every 1-2 weeks which tend to be less severe and of shorter duration.
Therapy may be followed by the Jarisch-Herxheimer reaction.
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