Louseborne Relapsing Fever among East African Refugees, Italy, 2015

Abstract

During June 9–September 30, 2015, five cases of louseborne relapsing fever were identified in Turin, Italy. All 5 cases were in young refugees from Somalia, 2 of whom had lived in Italy since 2011. Our report seems to confirm the possibility of local transmission of louse-borne relapsing fever.

Louse‐borne relapsing fever in Finland in two asylum seekers from Somalia

“…Alarmingly, some of the reported patients may have acquired the infection within Europe. For example, two patients had resided in Italy for years before getting infected with LBRF . Since the incubation period of LBRF is from a few days to 2 weeks, it is probable that also our patient 1 had acquired the infection after leaving Somalia.…”

“…European Centre for Disease Prevention and Control (ECDC) monitors the spread of LBRF in Europe and updated information can be found on the ECDC website . LBRF cases have been reported from many countries, and while the reported numbers of patients are small, they may merely represent the tip of the iceberg .…”

Fourth case of louse-borne relapsing fever in Young Migrant, Sicily, Italy, December 2015. Mini Review Article

“…Our search identified five publications reporting 26 cases of LBRF between July and October 2015 in migrants recently arrived in Europe: eight had been described in Italy (three in Sicily and five in Piedmont); one in Switzerland; two in the Netherlands; 15 in Germany (Bavaria). 3,8,10,11,12 Data regarding the clinical characteristics, diagnostic methods, therapy and outcome of these patients and of the new case we report, are analytically listed in Table 1. The majority of cases (21) involved Somali people, five cases Eritrean people, one case an Ethiopian patient.…”

Diagnosis of Louse-Borne Relapsing Fever despite Negative Microscopy in Two Asylum Seekers from Eastern Africa

“…20 In all published instances described as yet, migrants had stationed in overcrowded refugee camps in Libya before arriving to Italy after having crossed the Mediterranean Sea, with the exception of two patients who were probably infected in Turin, Italy, while sheltered in the same asylum as other individuals with the disease. 5 We report herein two additional cases of LBRF in refugees from Somalia and Sudan who were admitted to our Department of Infectious Diseases in Milan, Italy, in June 2016. We describe their clinical presentation, the difficulties encountered in diagnosing the disease, and finally we review all cases of LBRF imported to Europe thus far.…”

“…From June to December 2015, around 50 cases of LBRF were described among asylum seekers from Eastern Africa arriving to Europe with reports from Germany, Italy, Belgium, Switzerland, the Netherlands, and Finland. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] The latest report of imported LBRF in Europe regards a patient observed in Italy in June 2016 and coming from Mali. 20 In all published instances described as yet, migrants had stationed in overcrowded refugee camps in Libya before arriving to Italy after having crossed the Mediterranean Sea, with the exception of two patients who were probably infected in Turin, Italy, while sheltered in the same asylum as other individuals with the disease.…”