Tick-Borne Relapsing Fever (TBRF)

What is Tick-Borne Relapsing Fever (TBRF)

Tick-borne relapsing fever is a disease you can get from a tick. It is an infection caused by a bite from a tick that carries the bacteria Borrelia hermsii. In the United States, these ticks are usually found in higher elevations of the western states.

What are the symptoms of tick-born relapsing fever?

If you have TBRF, you probably have a fever that comes and goes. Some other symptoms of TBRF may include:

  • Headache
  • Chills
  • Sweats
  • Muscle or joint aches
  • Nausea
  • Vomiting

Causes & Risk Factors

Who is at risk for TBRF?

You are at risk for TBRF if you have had a tick bite or if you have found any ticks on your body in the past 3 weeks. People who spend time outdoors in areas where ticks are common, either for work or recreation, are at higher risk of getting any tick-borne disease.

Diagnosis & Tests

What can I do if I have TBRF?

See your doctor right away if you think you have TBRF. He or she can test your blood for TBRF or other tick-borne diseases.


What can I do if I have TBRF?

If you have TBRF, your doctor will most likely prescribe antibiotics to fight the bacteria.



How can I prevent tick-borne relapsing fever?

The best way to prevent tick-borne relapsing fever is to avoid being bitten by ticks. When you are outdoors, follow these guidelines:

  • Use tick repellents according to their instructions to help prevent bites. Use an insect repellent containing 20% to 30% DEET. Tick repellents that contain DEET can be put directly on your skin or on your clothing before going into tick-infested areas. Apply DEET sparingly to skin according to directions on the label. Don’t apply it to the face and hands of children and don’t use it on infants younger than 2 months of age. Repellents containing permethrin should be put onlyon clothing. Make sure to talk to your doctor before you use any tick repellent on your child. Your doctor can give you more information on what type and strength of repellent is safe to use.
  • Wear light-colored clothing that covers most of your skin when you go into the woods or an area overgrown with grass and bushes. This makes it easier to see and remove ticks from your clothing. Wear a long-sleeved shirt and wear pants instead of shorts. Tuck your pant legs into your socks or boots for added protection. Remember that ticks are usually found close to the ground, especially in moist, shaded areas. Check your entire body for ticks after you have been in tick-infested areas, and check your children and pets for ticks. Common tick bite locations include the back of the knees, groin area, underarms, ears, scalp and the back of the neck.
  • Remove any attached ticks as soon as possible. To remove an attached tick, use fine tweezers to grab the tick firmly by the head (or as close to the head as possible) and pull. Do not use heat (such as a lit match), petroleum jelly or other methods to try to make the tick “back out” on its own. These are not effective ways to remove a tick.
  • Wash the area where the tick was attached thoroughly with soap and water. Keep an eye on the area for a few weeks and note any changes. You should call your doctor if you develop a rash around the area where the tick was attached. Be sure to tell your doctor that you were bitten by a tick and when it happened. Only people who get sick and/or get a rash after being bitten by a tick need antibiotics. If you are bitten by a tick and don’t get sick or get a rash, you don’t need antibiotics.


Questions to Ask Your Doctor

  • I’ve been bitten by a tick. Should I call my doctor right away?
  • I’ve been bitten by a tick. Do I need any treatment?
  • If I need treatment, which antibiotic is best for me?
  • What tests can you do to ensure that I won’t get sick?
  • What tick or insect repellent should I use for my child?
  • Which tick or insect repellent is best for me?
  • I have HIV. Should I avoid areas where ticks may live?

Seek Additional Information


Tick-Borne Relapsing Fever  by C Roscoe, M.D. and T Epperly, M.D. (American Family PhysicianNovember 15, 2005,http://www.aafp.org/afp/20051115/2039.html  )


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