Symptoms of relapsing fever

The incubation period between the infection and the start of symptoms is typically five to ten days. The common clinical manifestations of RF include the sudden onset of episodes of high fever, up to 40^oC, with periods of shivering and chills, accompanied by headache, joint pain, dry cough and sometimes bleeding through the nose. About one third of patients develop tiny red or purple spots on the skin. The symptoms continue for three to nine days, while the immune system of the patient makes antibodies that attach to the bacteria and clear them from the blood, and the patient appears to recover. However, not all of the bacteria are destroyed. The numbers of bacteria gradually increase, and four to seven days after recovering from the first episode of fever, the patient 'relapses', i.e. the symptoms begin all over again. Almost all the organs are involved and there will be pain in the abdomen and an enlarged liver and spleen, in addition to the other symptoms. Without treatment with special antibiotics, 30% to 70% of cases can die from complications such as pneumonia and infection in the brain, leading to coma (a state of deep unconsciousness) and death.