Relapsing Fever in Tennessee

• Sudden onset of high fever (often >104°F / 40°C)
• Chills and severe headache
• Muscle and joint aches (myalgia and arthralgia)
• Nausea, vomiting, and abdominal pain
• Cycles of fever followed by periods of remission (days to weeks), then relapses (usually milder but recurring)

Relapsing Fever is primarily transmitted through vectors. *Louse-borne relapsing fever (LBRF)* spreads when infected body lice are crushed on the skin, and the bacteria enter through broken skin. *Tick-borne relapsing fever (TBRF)* is transmitted through the bite of infected soft-bodied *Ornithodoros* ticks, which typically feed at night.

• Avoid contact with ticks and lice; use insect repellents (e.g., DEET or permethrin-treated clothing) in endemic areas.
• Inspect skin and clothing for ticks after outdoor activities and remove them promptly and correctly.
• Maintain good personal hygiene and sanitation, especially in crowded conditions or where lice infestation is a risk.
• Control rodent populations around homes, as they can be hosts for infected ticks.