Table 1.
Clinical and laboratory characteristics of cases of Louse-borne relapsing fever imported in Europe, June 2015–June 2016 compared with an historical case file*
| N† patients | 55‡ | 62 |
|---|---|---|
| Sex, N (%) | 52 (94.5) M, 3 (5.9) F | 46 (74.2) M, 16 (25.8) F |
| Age, years median (range) | 20 (13–35) | 20§ (10–49) |
| Country of origin, N† (%) | Somalia 46 (83.6), Eritrea 6 (11.8), Ethiopia 1 (1.8), Sudan 1 (1.8), Mali (1.8) | Ethiopia 62 (100) |
| Fever | 51/55 (92.7%) | 97% |
| Fever > 38°C | 26/37 (70.3%) | 94% |
| Headache | 23/45 (51.1%) | 87% |
| Malaise | 11/45 (24.4%) | NR |
| Chills | 3/45 (6.7%) | 90% |
| Myalgia | 15/45 (33.3%) | 78% |
| Abdominal pain | 10/45 (22.2%) | 68% |
| Jaundice | 20/39 (51%) | 34% |
| Vomiting | 10/45 (22.2%) | 34% |
| Diarrhea | 2/45 (4.4%) | NR |
| Urinary symptoms | 5/45 (11.1%) | NR |
| Cough | 4/45 (8.9%) | 53% |
| Bleeding | 4/45 (8.9%)† | 23%‖ |
| Meningism | 3/55 (5.5%) | 39% |
| Hypotension (systolic pressure under 90 mm Hg) | 6/34 (17.6%) | 12% |
| Body lice recovered | 12/55 (21.8%) | NR |
| JHR | 34/55 (61.8%) | 100% |
| Concomitant malaria | 2/55 (3.6%) | 0 |
| Blood smears positive | 52/55 (94.5%) | 62/62 (100) |
| Death | 1/55 (1.8%) | 3/62 (4.8%) |
| Anemia (Hb < 12 g/dL) | 31/39 (79.5%) | 41/44 (93.1%) |
| Hb g/dl, median (range) | 10.7 (4.8–14.8) | 12§ (8.5–15.2) |
| Leukocitosis (WBC > 11,000/μL) | 16/38 (42.1%) | 14/44 (31.8%) |
| Leukopenia (WBC < 4,000/μL) | 4/38 (10.5%) | NR |
| WBC/μL, median (range) | 9,400 (1,600–25,500) | 8,230§ (2,900–24,400) |
| Thrombocytopenia (PLTs < 150,000/μL) | 49/54 (90.7%) | 34/37 (91.9%) |
| < 50,000/μL | 25/54 (46.3%) | NR |
| Platelets/μL, median (range) | 69,500 (4,000–610,000) | 136,000§ (41,000–295,000) |
| C Reactive Protein, mg/dL, median (range) | 284 (55–440.9) | NA |
| Increased | 47/47 (100%) | |
| PCT, ng/mL, median, (range) | 13,93 (0.95–62.1) | NA |
| Increased | 19/20 (95%) | |
| AST U/L, median (range) | 114 (30–282) | 169 (4–1,050) |
| Increased | 6/7 (85.7%) | 20/33 (60.6%) |
| ALT U/L, median (range) | 48 (7–489) | 43 (18–65) |
| Increased | 16/35 (45.7%) | 8/10 (80%) |
| Bilirubin, total mg/dL | 1.8 (0.3–12.3) | 7§ (0.3–38.4) |
| Increased | 31/38 (81.6%) | 22/37 (59.5%) |
| Serum creatinine, mg/dL, median (range) | 2.4 (0.9–4.7) | NR |
| Increased | 7/35 (20%) |
*
Ref. 2.
†
2 epistaxis, 1 hematuria, 1 hemoptysis.
‡
Including the two patients described herein.
§
Mean value; ALT = alanine aminotransferase; AST = aspartate aminotransferase; JHR = Jarisch–Herxheimer reaction; PCT = procalcitonin.
‖
Epistaxis; NA = not available; NR = not reported.