Tick Typhus Fever

Going under a host of names, Boutonneuse fever, Mediterranean-spotted fever, African tick typhus, Indian tick typhus, Siberian tick typhus, Queensland tick typhus, to give but a few, this similar group of infections has been reported from different parts of the world.

Organism Rickettsia conori, R. africae, R. siberica and R. australis.

Clinical features Generally, a mild illness of a few days, infection is characterized by an eschar at the site of the tick bite and regional lymphadenopathy. There is fever and a gen eralized maculo-papular rash, resolving spontaneously after about 1 week.

Diagnosis is usually on clinical appearance following history of a tick bite, but can be confirmed with serological tests or PCR.

Transmission The reservoir of infection is the dog tick (Rhipicephalus sanguineus in the Mediterranean area, and Amblyomma hebreum in Africa), which inadvertently moves from the dog to its human handler during their close association. Alternatively, humans acquire infection from passing through scrub forest inhabited by rodents and their ticks (Ixodes holocyclus in Australia, Dermacentor and Haemaphy-salis in Siberia), the rodent serving as a secondary reservoir.

Incubation period 1-15 days (generally 5-7 days).

Period of communicability Not transmitted from human-to-human, the tick remaining infected for life.

Occurrence and distribution Found in slightly different forms in the Mediterranean region, Africa, Indian sub-continent, Australia and northeast Asia.

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