African Tick Bite Fever - Symptoms, Causes, Risk Factors, Diagnosis, Treatment, and Prevention

Introduction:

If one is fond of traveling in the wild, keep checking for ticks around the places one chooses to stay, as a few ticks could be infectious. One in a bunch of diseases a traveler suffers is tick bite-induced spotted fever, a tick-borne illness commonly occurring in travelers returning from southern parts of Africa and the West Indies. It is a zoonosis infection, which indicates an animal infection contracted by a human. The incubation period of African tick bite fever is usually five to seven days or may be up to 10 days also. The article talks in detail about African tick bite fever, its signs and symptoms, causes, features, and treatment options available.

What Are the Symptoms of an African Tick Bite Fever?

After encountering the tick bite, symptoms usually occur after the incubation period, which is not more than ten days. They present with flu-like symptoms; the common symptoms of African tick bite fever include:

• Fever.

• Neck muscle pain.

• Headaches.

• Weakness and fatigue.

• General myalgia (muscle pain).

• Eschar (a lesion that occurs at the site of the bite) is usually dark in the center and surrounded by red margins. Eschar is not always very obvious and can appear in rarely noticeable areas such as the scalp hidden by the hair, the back of the ears, and the anogenital region.

• Generalized cutaneous (skin) rash, which is maculopapular.

• Lymph node enlargement.

• Aphthous stomatitis (shallow, small, or painful ulcers in the mouth) and lymphangitis (inflammation of the lymphatic vessels) are the less common symptoms seen in this disease.

• Arthritis (inflammation of joints), encephalitis (swollen brain due to infection or allergies), myocarditis (inflammation of the heart muscles), or neuropathy (symptoms caused due to damage to nerves) can occur rarely, and few cases have been reported as well.

What Causes African Tick Bite Fever?

• It occurs due to the biting of an Amblyomma tick (a group of hard ticks commonly seen hardly attached to the skin and feeding on dogs) infected with Rickettsia Africa, a gram-negative intracellular bacteria.

• These ticks usually get contracted to the pets or belongings carried during the travel and then transferred to the humans.

• The tick has to stay in touch with the skin for at least 24 to 48 hours to transmit the disease to the contracted person.

Who Is at Risk of an African Tick Bite Fever?

• Returning travelers from African countries, primarily those who enjoy outdoor activities like hiking, camping, games involving the outdoors, and exposure to wild plants, bushes, and grassy locations, are put at risk for African tick bites.

• It usually affects otherwise healthy middle-aged people.

• The incidence of the disease is severe in older people as the underlying diseases or the weakness can aggravate it.

• Usually, the ticks are more active in rainy seasons. More common among travelers who visit African and European countries, especially from November to April.

What Are the Features of African Tick Fever?

• The tick bite usually happens in the legs and then transfers to the moist skin areas like the axilla and groin.

• Eschar is a unique feature of this disease and can be single or multiple.

• The rash that occurs can be either generalized or localized.

• The condition ranges from mild to severe. It has not shown any fatality cases.

• These infections are not usually transmitted among humans.

How Is African Tick Fever Diagnosed?

• Eschar, if evident, usually represents the disease other than that the symptoms are similar to the regular flu.

• Blood tests are performed, which show elevated white blood cells.

• The biopsy of the eschar or the rash specimen is collected for laboratory examination to confirm the diagnosis.

• If the ticks are collected and preserved, they are also subjected to laboratory examination.

• Immunofluorescence assays and ELISA (enzyme-linked immunosorbent assay) are the other tests performed.

What Are the Laboratory Diagnoses of African Tick Bite Fever?

Laboratory diagnosis of African tick Bite fever can be done by:

• Comparing acute and convalescent samples of four to six weeks following the onset of illness for evidence of seroconversion in IgG (immunoglobulin G) antibodies.

• The condition can also be confirmed by using IFA (immunofluorescent assay) or detection of Rickettsial DNA (deoxyribonucleic acid) by PCR (polymerase chain reaction) of eschar swab, whole blood, or skin biopsy.

How Is African Tick Fever Treated?

• The laboratory tests take time to come out; in such cases, it is not advisable to wait till one gets the reports; instead, start with the antibiotics immediately.

• The disease has shown favorable results and rapid recovery after Doxycycline antibiotic therapy. The usually recommended dosage is the capsule Doxycycline 200 mg (milligrams) for seven to ten days.

• Antibiotics like Ciprofloxacin are used as well as a replacement for Doxycycline.

• The general recovery rate is slow, and it takes around 15 days to a month for the eschar to heal.

How to Prevent and Protect From African Tick Fever?

• The prevention of tick bites is not possible without following the safety protocols as there is no existing vaccine or medications to prevent infections caused by tick bites.

• Avoid getting in close contact with areas that are highly prone to ticks, such as grassy bushes areas, while performing outdoor activities and traveling to rural areas.

• Examine the pets for any ticks; in case they have ticks, get them cleaned using anti-tick shampoos or powders.

• Try to follow the trail rather than taking unclear paths with outgrown plants and bushes when hiking.

• Check for any ticks in the clothing and body when one reaches home from outdoor activities. Take a shower as one reaches home.

• When washing the clothing with ticks, use hot water as cold and lukewarm water cannot kill ticks.

• When traveling in tick-prone areas, use repellents with Picaridin 20 percent or DEET (N, N-Diethyl-meta-toluamide) 20 to 30 percent to prevent tick bites.

• Use Permethrin for the belongings and clothing.

• Wear fully covered, breathable clothes, and tuck the pants into the sock.

• Do not sit on the grassy ground without mats.

• Ticks that are present in the skin should be removed using tweezers by pulling them and grabbing their head or body when trying to remove them.

• The removed ticks are stored in live conditions. If they are dead, they can be frozen in zip locks and should be taken when visiting a physician to perform tests on them.

• After removing the tick, wash the tick-contracted skin with antiseptic soaps, water, or disinfectants.

• If one notices any symptoms following the tick bite, report it to the physician for management.

Conclusion:

If a person is a traveler or loves to explore, minding a few protection and safety protocols can keep one safe from this disease. The African tick bite fever is not a severe condition and, even if infected, is an easily treatable condition. However, one must avail of timely medical help in case any signs or symptoms of African tick bite fever are experienced.