RELAPSING FEVER 9 



RELAPSING FEVER. 

 DEFINITION. 



An acute infectious disease or group of diseases: — 



Caused by the SpirochcTtes, S. recurrentis, S. novyi, S. duttoni, 

 S. carteri. 



Transmitted by bed bugs, body lice and ticks. 



Characterized by sudden onset, definite course (r to 7 days), rapid 

 subsidence and indefinite relapses. 



HISTORICAL. 



A relapsing fever was known to Hippocrates in Thasos, which he 

 described. 



The next notice of it was by Rutty of the Dublin epidemic in 1770. 



In 1873 Obermeier published his discovery of the causative spiro- 

 ch^ete during a Berlin epidemic. 



In 1897 Tictin proved the bed bug as a carrier. 



In 1904 Philip, Ross and Milne in Uganda discovered that the tick 

 Ornithodorus moubata was the carrier of the African Tick Fever. 



Dutton and Todd in the Congo confirmed this, and proved that 

 the parasite could pass into the egg and larva, thus infecting succeed- 

 ing generations. 



Napoleon's Grand Army was attacked by it in the great retreat 

 from Moscow. The allied Armies were affected by it during the 

 Crimean War, and both armies suffered from it in the Russo-Turkish 

 War. 



DISTRIBUTION. 



Relapsing Fever is found in Europe, Asia, Africa, North, Central 

 and South America, and probably in Australia. 



The Relapsing fever of Europe is caused by S. recurrentis or 

 obermeieri ; 



The Relapsing fever of America is caused by S. novyi ; 



The Relapsing fever of Asia is caused by S. duttoni ; 



The Relapsing fever of Africa is caused by S. carteri. 



The number of the spirochaetes present in the peripheral blood 

 during infection is variable according to the type of parasite; thus in 

 the African type the infection is light, in the European type it is 

 heavy, and in the Indian type it is variable. 



The different types will now be considered seriatim. 



EUROPEAN RELAPSING FEVER. 

 ETIOLOGY. 



The causative organism is S. recurrentis (obermeieri), which is 

 found in the peripheral blood during attacks, but is usually absent 

 between them. Its absence from the peripheral blood during apyrexial 



