Epidemiological Study on Tick-Borne (Acari: Argasidae) Relapsing Fever in Kurdistan Province, Iran, 2000-2004

Authors

  • Javad Rafinejad
  • Khadijeh Shemshad
  • Omid Banafshi

Abstract

Tick-borne relapsing fever is an acute infectious disease transmitted to humans by Ornithodoros tholozani, and it is a notifiable disease in Kurdistan Province, Iran. This cross-sectional survey was carried out from 2000 to 2004. The main aim of this study was to ascertain the prevalence of tick-borne relapsing fever in Kurdistan Province. The prevalence and incidence of tick-borne relapsing fever was monitored by daily clinical surveillance and by thin and thick blood smears of individuals with a fever. In confirmed cases, there was febrile illness, and spirochetes were identified on smears of peripheral blood. A field survey on presence of Ornithodoros tholozani in Bijar county villages was carried out and investigated for the detection of Borrelia spp. A total number of 97 cases including 88 cases from rural areas and 9 cases from urban areas were recorded over 5 years. Epidemiological studies on O. tholozani ticks collected from the several locations of villages indicated that 2 of the 20 studied villages (10%) were infested by the vector tick, O. tholozani. The presence of O. tholozani in most villages investigated and its infection rate suggest that tick-borne relapsing fever is a common cause of fever in most rural areas of Kurdistan Province. Results of the study demonstrate that tick-borne relapsing fever is under-recognized and under-reported, and the pathogens may be wrongly identified as malaria parasites. The study showed that tick-borne relapsing fever should be considered as an important public health priority in the study area.

Resumen: La fiebre recurrente es una enfermedad aguda infecciosa transmitida por las garrapatas Ornithodoros tholozani a los humanos, es considerada una enfermedad de declaración obligatoria en la provincia de Kurdistán, Irán. Se realizó esta colecta a travez de la región desde 2000 hasta 2004. El objetivo principal de este estudio fue para determinar la prevalencia de la fiebre recurrente transmitida por garrapatas en la provincia de Kurdistán. Se monitoreó la prevalencia y la incidencia de fiebre recurrente transmitida por garrapatas por medio de la vigilancia clínica diaria y por manchas de sangre aguado y espeso de individuos con fiebre. En los casos confirmados, se presentó una enfermedad febril y las espiroquetas fueron identificadas en las manchas de sangre periférica. Se realizó un estudio de campo sobre la presencia de Ornithodoros tholozani en los pueblos de Bijar para evaluar la presencia de Borrelia spp. Se registraron un total de 97 casos, incluyendo 88 casos de las zonas rurales y 9 casos de las zonas urbanas durante 5 años. Los estudios epidemiológicos sobre las garrapatas Ornithodoros tholozani recolectadas de varios pueblos indican que 2 de los 20 pueblos estudiados (10%) estaban infestados por esta garrapata vector. La presencia de Ornithodoros tholozani en la mayoría de los pueblos investigados y su tasa de infección sugieren que la fiebre recurrente transmitida por estas garrapatas es una de las causas comunes de fiebre en la mayoría de las zonas rurales de la provincia de Kurdistán. Los resultados del estudio demuestran que la fiebre recurrente transmitida por las garrapatas no es bien reconocida y reportada y los agentes patógenos pueden ser erróneamente identificados como parásitos de la malaria. Los resultados del estudio, mostraron que la fiebre recurrente transmitida por garrapatas debe ser considerada como una prioridad de salud pública importante en el área de este estudio.

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Published

2012-09-01

Issue

Vol. 95, No. 3 (September 2012)

Section

Research Papers

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