Fourth case of louse-borne relapsing fever in Young Migrant, Sicily, Italy, December 2015. Mini Review Article

Public Health. 2016 Oct;139:22-26. doi: 10.1016/j.puhe.2016.05.019. Epub 2016 Jun 21.


Objectives: Currently louse-borne relapsing fever (LBRF) is primarily found in limited endemic foci in Ethiopia, Somalia and Sudan; no case of imported LBRF has been reported in Europe in the 9 years prior to 2015. The aim of our paper is to describe a new case of imported LBRF detected in Sicily, Italy, and to review all cases reported in migrants arrived in Europe in the last 10 years.

Study design: Mini review of all published cases of louse-borne relapsing fever in Europe in the last 10 years.

Methods: A computerized search without language restriction was conducted using PubMed combining the terms '(louse-borne relapsing fever or LBRF or recurrentis) and (refugee or Europe or migrant)' without limits. Furthermore, the 'Ahead-of-Print Articles' of the top 10 journals (ranked by Impact factor - Web of Science) of Infectious diseases and of Epidemiology were checked.

Results: Our search identified 26 cases of LBRF between July and October 2015 in migrants recently arrived in Europe: 8 had been described in Italy; 1 in Switzerland; 2 in the Netherlands; 15 in Germany. We describe data regarding the clinical characteristics, diagnostic methods, therapy and outcome of these patients and of the new case.

Conclusions: LBRF by Borrelia recurrentis should be considered among the clinical hypotheses in migrants presenting with fever, headache, chills, sweating, arthralgia, myalgia, dizziness, nausea and vomiting.

Keywords: Borrelia recurrentis; Europe; Louse-borne relapsing fever; Refugees.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Borrelia / isolation & purification*
  • Diagnosis, Differential
  • Humans
  • Lice Infestations / complications*
  • Male
  • Relapsing Fever / diagnosis*
  • Sicily
  • Somalia / ethnology
  • Transients and Migrants* / statistics & numerical data