NEW ORLEANS, Sept. 17 -- People who spend a lot of time in remote cabins in the United States and Canada often report they suffer from 'cabin fever,' and now scientists said Tuesday that at least one form of fever is not psychological -- it's caused by a tick-borne bacteria. The fever, caused by infection from the bacterium Borrelia hermsii, is transmitted through the bite of a tick that feeds on sleeping persons in rural cabins, lakeside vacation homes and even permanent residences. Dr. Mark Dworkin of the Centers for Disease Control and Prevention Surveillance Branch in Atlanta, and colleagues tracked 182 cases of tick-borne relapsing fever (TBRF) during a retrospective study of health records in Washington, Idaho, Oregon and British Columbia during a 15- year period ending in 1995. In a presentation at the annual meeting of the Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), sponsored by the American Society of Microbiology in New Orleans, Dworkin said that TBRF is characterized by high fever, shaking chills, severe headache, muscle aches and sometimes abdominal pain, rash, diarrhea or a predisposition to bleeding. 'Patients have complained of the worst headaches of their life and literally stated that they felt as if they were 'going to die',' Dworkin said. While many diseases are transmitted by ticks, including Rocky Mountain Spotted Fever, Lyme Disease and ehrlichiosis, Dworkin said TBRF often goes unrecognized until patients have relapsed several times. Often, he said, the disease is not reported to state or provincial health departments.
TBRF may also be misdiagnosed as Lyme Disease and can result in long- term, expensive intravenous antibiotic therapy, instead of relatively inexpensive oral medications which can successfully treat TBRF, he said. 'We recommend increased public and physician awareness of the diseases and its complications,' Dworkin said. 'TBRF is preventable with rodent control in rural dwellings and tick repellent worn at night. ' In another study presented at ICAAC Tuesday, researchers at the University of Minnesota School of Medicine said they have found several available medications which can kill the bacteria that has caused an outbreak of human granulocytic ehrlichiosis (HGE), a disease reported in more than 200 people across the Midwest and Northeast and which has up to a 5 percent mortality in untreated cases. Dr. Jesse Goodman, associate professor of medicine, said use of tetracycline or doxycycline are effective against the tick-borne bacterium, Ixodes scapularis, that causes HGE. But the medications are not recommended for children under age 9. 'We identified two other types of antibiotics, called quinolones and rifamycins, which are also active against the bacteria,' Goodman said. While the drugs work in the test tube to kill the bacteria, Goodman said clinical trials are necessary to prove the drugs work. Most drugs used in treating Lyme Disease don't work against HGE, Goodman said. Another ICAAC study examined the outbreak of HGE in Westchester County, N.Y. In that case 18 adults were infected with HGE, but treatment with doxycycline cleared the disease within 24 to 48 hours, said Dr. Maria Aguero-Rosenfeld of the Westchester County Medical Center, Valhalla.
