Maryland

Relapsing Fever, Tick-Borne in Maryland

Relapsing Fever, Tick-Borne (TBRF) is a bacterial infection caused by several species of *Borrelia* bacteria. It is characterized by recurring episodes of high fever and is primarily found in people exposed to infected soft ticks, often in rustic cabins, caves, or rural settings in endemic areas.

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What is Relapsing Fever, Tick-Borne?

Relapsing fever has been recognized for centuries, with early descriptions dating back to antiquity. The *Borrelia* spirochetes responsible for the disease were identified in the late 19th and early 20th centuries. Historically, relapsing fevers caused significant epidemics and morbidity, especially in regions with poor hygiene and limited vector control, and were a major public health concern during wars and famines.

Symptoms

First Febrile Episode: Sudden onset of high fever, headache, muscle and joint aches, chills, nausea, vomiting, and sometimes a rash.
Afebrile Period: A period of 3-10 days where symptoms subside completely or significantly improve.
Relapses: Return of fever and other symptoms, often milder than the initial episode but can recur multiple times.
Other possible symptoms: Jaundice, cough, abdominal pain, neurological symptoms.

Transmission

Relapsing Fever, Tick-Borne is primarily transmitted to humans through the bite of infected *Ornithodoros* (soft) ticks. These nocturnal ticks typically feed for short periods (15-30 minutes) while a person is sleeping. The ticks acquire the *Borrelia* bacteria from reservoirs like rodents (e.g., squirrels, chipmunks, mice) and other small mammals. It is not transmitted from person to person.

Contagious Period: Varies by disease

Prevention

Avoid tick exposure: Use insect repellents containing DEET or picaridin when in endemic areas.
Protective clothing: Wear long sleeves and pants, especially at night or when visiting areas known to harbor ticks.
Tick checks: Inspect skin and clothing thoroughly after spending time outdoors.
Rodent control: Reduce rodent populations around homes and cabins to limit tick habitats.
Seal entry points: Block potential entry points for rodents and ticks in dwellings.
No vaccine: Currently, no vaccine is available for TBRF.

Maryland Health Resources

Local health department information and state-specific prevention guidance

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Maryland Health Department

For official state health alerts, vaccination locations, and public health guidance specific to Maryland, visit your state health department's website.

→ Maryland Department of Health → CDC Relapsing Fever, Tick-Borne Information → CDC Health Topics

Understanding Relapsing Fever, Tick-Borne: Key Questions

Whether you live in Maryland or are traveling there, knowing the symptoms, timeline, and when to seek care helps you act quickly if exposure occurs.

When to Seek Care

Seek care if you experience severe dehydration, bloody stools, high fever, or symptoms lasting more than 3 days. Children under 5, adults over 65, and immunocompromised individuals should seek care earlier.

Emergency symptoms: Severe dehydration, inability to keep fluids down for 12 or more hours, or neurological symptoms require emergency care.

Expert Resources & References

Trusted information from leading health organizations

CDC

Official guidance from the U.S. Centers for Disease Control and Prevention

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WHO

Global disease surveillance and guidelines from the World Health Organization

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Research

Latest peer-reviewed research and clinical studies

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Medically Reviewed Content

Disease information on Virus Watcher is reviewed by our Chief Epidemiologist, a former CDC lead analyst for FluSight forecasting. Outbreak data is aggregated from verified sources including BEACON, ProMED, WHO, CDC, and 50+ national health agencies. This information is for educational purposes and should not replace professional medical advice.

Last reviewed: 2026-07-18

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