Back to...

GET VISIBLE! Advertise Here. Find Out More

Share Our Stories! - Click Here


Proof Muslims Brought Tick Borne Relapsing Fever
& Malaria Co-Infection To Germany

From Patricia Doyle

Hello Jeff  - Here is the proof that the co infection of Relapse Fever/Malaria came to Germany via Afghanistan.  REFUGEE Transmitted Disease.  What more can we say.  Refugees are not screened for health by UN.  Germany is terribly infected country with everything from TB to Malaria, to Typhus and Malaria co infection Typhus.  etc etc.

Refugees = Europe Disease Outbreak

More proof, check out and see the disease map. Covered in outbreaks.


Proof refugees bring diseases


A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases

Date: Fri 8 Sep 2017
From: Timo Wolf <> [edited]

A 43-year-old female patient was admitted to Frankfurt University Hospital on [Sun 3 Sep 2017]. She is a resident of Germany and had returned from a visit to her family in Afghanistan 5 weeks before admission. A few days after her return to Germany, she had developed fever and shivering. The fever was reported to occur every 2nd to 3rd day.

Approximately a week before admission, she also developed generalized abdominal pain without vomiting or diarrhea. Another member of the travel group also visiting friends and relatives had been previously diagnosed with malaria. This prompted the patient to see her local doctor, who performed a Malaria POCT with negative result. As the symptoms persisted, she was admitted to Frankfurt University hospital's emergency department. A QBC and thick film was performed and showed Malaria parasites consistent with _Plasmodium vivax_.

Treatment with Arthemer/Lumefantrin was initiated. Interestingly, the thick film also showed spirochaetes in every 2nd to 3rd visual field, consistent with tick-borne relapsing fever (TBRF).

The patient received doxycycline for the TBRF. She improved 48 hours after doxycycline treatment has been initiated. There was no Jarisch-Herxheimer reaction. The samples were sent for further PCR testing, and cultivation of the bacteria is currently attempted.

TBRF is a zoonotic, vector-borne disease. The most common vector is _Ornithodoros tholozani_. In Eurasian forms, the disease is mostly attributed mainly to _Borrelia persica_. Other species include _Borrelia caucasica_, _Borrelia latyschewii_, _Borrelia microtii_, and _Borrelia baltazardi_.

A coinfection between TBRF and _Plasmodium vivax_ has rarely been reported in literature. There was a case of an Isreali woman with vivax malaria / suspected TBRF described after extensive journey throughout Eastern Africa (Miron D et al. J Travel Med 2004;11:115-116).

Privatdozent Dr. Timo Wolf;
Prof. Dr. Gudrun Just-Nöbling
Dr. Philipp De Leuw
For the Frankfurt University Hospital Infectious Diseases team.
University Hospital Frankfurt,

[ProMED thanks Privatdozent Dr. Timo Wolf and Professor Gudrun Just-Nöbling for communicating this interesting report. The report remind us that patients may have more than one diagnose and concommittant infections should be considered if the treatment response is not as expected. In this case is the laboratory microscopist who saw the spirochaetes. _Plasmodium vivax_ is endemic in Afghanistan below 1800 meters [1.11 mi] altitude.

It is assumed that the _Borrelia_ species seen here was transmitted by ticks, but it is also possible that the infection was louse-borne recurrent fever caused by _Borrelia recurrentis_. Genotyping will resolve this issue. - Mod.EP

The HealthMap/ProMED map of Afghanistan can be found at: <>]

[Relapsing fever is a bacterial infection caused by certain species of the spirochete _Borrelia_. These organisms are able to periodically change their surface protein molecules to evade the host's immune response, thus causing a relapsing illness. Following an incubation period of about 7 days, the illness is characterized by recurring episodes of high fever, headache, muscle and joint pain, nausea and vomiting, each episode lasting several days, followed by a several-day asymptomatic interval.

Complications may include involvement of the lungs (ARDS; acute respiratory distress syndrome), central nervous system, spinal cord, eyes, heart, and liver. The bacteremia is intense (more than 10 000 organisms per ml of blood) during febrile episodes, which allows detection of organisms on a Wright-Giemsa stained blood smear. Thick blood smears are more sensitive than thin smears.

Relapsing fever can be transmitted by ticks or lice. Louse-borne relapsing fever (LBRF) is caused by a single _Borrelia_ species, _B. recurrentis_, transmitted through abraded skin when the body louse is crushed during scratching. LBRF is endemic in Ethiopia, Sudan, Eritrea, and Somalia. Outbreaks are found in developing regions affected by war and in refugee camps characterized by overcrowding and poor personal hygiene. Tick-borne relapsing fever can be transmitted by soft or hard-bodied ticks. While mammals and reptiles may serve as a reservoir for tick-borne _Borrelia_ species, humans are the only host of _B. recurrentis_.

Treatment of relapsing fever consists of either a tetracycline (such as doxycycline), a macrolide (such as erythromycin), penicillin, or other beta-lactam antibiotics (such as ceftriaxone). LBRF can be treated effectively with a single dose of the antibiotic (, whereas treatment of TBRF requires 7-10 days to prevent relapse. When initiating antibiotic therapy, all patients should be observed for a Jarisch-Herxheimer reaction. The reaction, caused by massive release of tumor necrosis factor alpha (TNF-alpha), interleukin-6, interleukin-8, and other cytokines, is manifest by a worsening of symptoms with rigors, tachycardia, sweating, hypotension, and high fever, occurs in over 50 percent of cases. - Mod.ML]

See Also

Malaria - Afghanistan, USA military: 20120223.1050430
Malaria - Afghanistan ex Bahamas (Great Exuma) 20080417.1380
Malaria - Afghanistan (Badghis) 20021023.5626
Typhus & malaria - Afghanistan 19990219.0213