Louseborne relapsing fever (LRF) was once widely distributed in all geographic areas, including Europe and North America, occurring in association with poverty and overcrowding. In Europe, it virtually disappeared after World War I in parallel with improved living conditions that led to substantially decreased body lice infestations in humans (1). Currently, LRF is reported mostly from Ethiopia and surrounding countries, where it is endemic (2): in this region, it is an extremely common infection with substantial mortality.
The causative agent is the spirochete bacterium Borrelia recurrentis. In nature, the only relevant vector is the body louse, which feeds only on humans; no other reservoir for this infection is known (1,3). The incubation period is 3–12 days. We report 5 cases of LRF in refugees to Italy from East Africa that occurred during 2015. ...
http://wwwnc.cdc.gov/eid/article/22/2/15-1768_article
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