{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T18:47:56Z","timestamp":1792003676472,"version":"4.4.0"},"reference-count":167,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2021,3,11]],"date-time":"2021-03-11T00:00:00Z","timestamp":1615420800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:p>\n                    Louse-borne relapsing fever (LBRF) is a classical epidemic disease, which in the past was associated with war, famine, poverty, forced migration, and crowding under poor hygienic conditions around the world. The disease\u2019s causative pathogen, the spirochete bacterium\n                    <jats:italic>Borrelia recurrentis<\/jats:italic>\n                    , is confined to humans and transmitted by a single vector, the human body louse\n                    <jats:italic>Pediculus humanus<\/jats:italic>\n                    . Since the disease has had its heyday before the days of modern medicine, many of its aspects have never been formally studied and to date, remain incompletely understood. In order to shed light on some of these aspects, we have systematically reviewed the accessible literature on LBRF, since the recognition of its mode of transmission in 1907, and summarized the existing data on epidemiology and diagnostic aspects of the disease. Publications were identified by using a predefined search strategy on electronic databases and a subsequent review of the reference lists of the obtained publications. All publications reporting patients with a confirmed diagnosis of LBRF published in English, French, German, and Spanish since 1907 were included. Data extraction followed a predefined protocol and included a grading system to judge the certainty of the diagnosis of reported cases. Historically, Ethiopia is considered a stronghold of LBRF. The recognition of LBRF among East African migrants (originating from Somalia, Eritrea, and Ethiopia) arriving to Europe in the course of the recent migration flow from this region suggests that this epidemiological focus ostensibly persists. Currently, there is neither evidence to support or refute active transmission foci of LBRF elsewhere on the African continent, in Latin America, or in Asia. Microscopy remains the most commonly used method to diagnose LBRF. Data are lacking on sensitivity and specificity of most diagnostic methods.\n                  <\/jats:p>","DOI":"10.1371\/journal.pntd.0008564","type":"journal-article","created":{"date-parts":[[2021,3,11]],"date-time":"2021-03-11T13:29:46Z","timestamp":1615469386000},"page":"e0008564","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":22,"title":["Louse-borne relapsing fever\u2014A systematic review and analysis of the literature: Part 1\u2014Epidemiology and diagnostic aspects"],"prefix":"10.1371","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4638-3820","authenticated-orcid":true,"given":"Pascal","family":"Kahlig","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel H.","family":"Paris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Neumayr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,3,11]]},"reference":[{"key":"pntd.0008564.ref001","volume-title":"The Medical Works of Hippocrates. A new translation\u2026 by John Chadwick\u2026 and W.N. Mann. [With a portrait.]","author":"Hippocrates","year":"1950"},{"key":"pntd.0008564.ref002","unstructured":"Balthazard M. Relapsing fevers. In: National Academy of Sciences WDC, editor. Tropical Health; a Report on a Study of Needs and Resources1962. p. 497."},{"key":"pntd.0008564.ref003","first-page":"410","article-title":"Notice of a febrile disorder which has prevailed at Edinburgh during the summer of 1843","volume":"60","author":"D. Craigie","year":"1843","journal-title":"Edinburgh Med Surg J"},{"key":"pntd.0008564.ref004","first-page":"201","article-title":"On some of the characters which distinguish the fever at present epidemic from typhus fever","volume":"61","author":"W. Henderson","year":"1844","journal-title":"Edinburgh Med Surg J"},{"issue":"11","key":"pntd.0008564.ref005","first-page":"681","article-title":"An Epidemic of Relapsing Fever in Edinburgh In 1843","volume":"50","author":"EDW Greig","year":"1943","journal-title":"Edinb Med J"},{"key":"pntd.0008564.ref006","first-page":"145","article-title":"Vorkommen feinster eine eigenbewegung zeigender faden im blute von rekurrenskranken","volume":"11","author":"O. 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Doury","year":"1996","journal-title":"Hist Sci Med"},{"key":"pntd.0008564.ref009","first-page":"174","article-title":"Fi\u00e8vre r\u00e9currente du Sud-Oranais et Pediculus vestimenti","volume":"1","author":"EHF Sergent","year":"1908","journal-title":"Bull Soc Pathol Exot"},{"issue":"4","key":"pntd.0008564.ref010","doi-asserted-by":"crossref","first-page":"1115","DOI":"10.1111\/j.1365-2672.2009.04598.x","article-title":"Relapsing fever\u2014a forgotten disease revealed","volume":"108","author":"SJ Cutler","year":"2010","journal-title":"J Appl Microbiol"},{"key":"pntd.0008564.ref011","first-page":"295","volume-title":"Tropical Infectious Diseases","author":"AG Barbour","year":"2011"},{"issue":"5","key":"pntd.0008564.ref012","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1016\/j.cmi.2015.04.022","article-title":"Neglected Bacterial Zoonoses","volume":"21","author":"I Chikeka","year":"2015","journal-title":"Clin Microbiol Infect"},{"issue":"14","key":"pntd.0008564.ref013","first-page":"E133","article-title":"25 Cases of Louse-borne Relapsing Fever in Refugees from East Africa","volume":"141","author":"M Seilmaier","year":"2016","journal-title":"Dtsch Med Wochenschr"},{"issue":"1","key":"pntd.0008564.ref014","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1111\/apm.12635","article-title":"Louse-borne relapsing fever in Finland in two asylum seekers from Somalia","volume":"125","author":"J Hytonen","year":"2017","journal-title":"Apmis"},{"issue":"3","key":"pntd.0008564.ref015","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1007\/s15010-017-0987-2","article-title":"Louse-borne relapsing fever in a refugee from Mali","volume":"45","author":"C Grecchi","year":"2017","journal-title":"Infection"},{"issue":"1","key":"pntd.0008564.ref016","doi-asserted-by":"crossref","DOI":"10.1186\/s12879-016-1541-z","article-title":"Louse-borne relapsing fever\u2014report of four cases in Switzerland, June-December 2015","volume":"16","author":"M Osthoff","year":"2016","journal-title":"BMC Infect Dis."},{"issue":"3","key":"pntd.0008564.ref017","article-title":"Louse-borne relapsing fever in a refugee from Somalia arriving in Belgium","volume":"23","author":"G Darcis","year":"2016","journal-title":"J Travel Med."},{"issue":"1","key":"pntd.0008564.ref018","first-page":"93","article-title":"The Evolution of the Epidemic of Relapsing Fever, 1942\u20131946","volume":"1","author":"M Gaud","year":"1948","journal-title":"Bull World Health Organ"},{"issue":"1","key":"pntd.0008564.ref019","first-page":"69","article-title":"Epidemiological Study on Relapsing Fever in North Africa (1943\u20131945)","volume":"1","author":"M Gaud","year":"1948","journal-title":"Bull World Health Organ"},{"issue":"1","key":"pntd.0008564.ref020","first-page":"129","article-title":"A clinical and laboratory study of 62 cases in ethiopia and a reconsideration of the literature","volume":"39","author":"ADM Bryceson","year":"1970","journal-title":"QJM"},{"issue":"2","key":"pntd.0008564.ref021","doi-asserted-by":"crossref","first-page":"288","DOI":"10.4269\/ajtmh.12-0691","article-title":"Review article: Relapsing fever borreliae in Africa","volume":"89","author":"H Elbir","year":"2013","journal-title":"Am J Trop Med Hyg"},{"issue":"4","key":"pntd.0008564.ref022","first-page":"335","article-title":"Relapsing fevers. 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