title: [Rickettsia africae infection among participants in a women's safari to South Africa].
abstract: BACKGROUND
  In recent years infections with Rickettsia africae (African tick bite fever) have become a common and important cause of febrile illness among travelers returning from Sub-Saharan Africa, primarily from South Africa.
  
  
  METHODS
  A prospective observational study, involving 671 participants in safaris to South Africa during 2008.
  
  
  RESULTS
  Nine participants (1.34%) were diagnosed with African tick bite fever. The symptoms included fever, headache, muscle pain, lymphadenopathy, vesicular rash, and an eschar. Lack of familiarity with the disease led to an incorrect diagnosis and delayed treatment with doxycycline in a number of cases.
  
  
  CONCLUSIONS
  African tick bite fever is frequent among Israeli travelers to Sub-Saharan Africa. Travelers should be counseled on tick bite prevention. Increased awareness of the disease among Israeli physicians may prevent diagnostic delays.
authors.affiliation: The Center for Geographic Medicine and Department of Medicine C, Chaim Sheba Medical Center, Tel Hashomer, and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Drorit
authors.initials: D
authors.lastname: Atias
authors.forename: Eyal
authors.initials: E
authors.lastname: Meltzer
authors.forename: Eyal
authors.initials: E
authors.lastname: Leshem
authors.forename: Eli
authors.initials: E
authors.lastname: Schwartz
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D057210:Delayed Diagnosis; D003951:Diagnostic Errors; D004318:Doxycycline / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007557:Israel; D008875:Middle Aged; D012281:Rickettsia / Q000302:isolation & purification*; D012282:Rickettsia Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D013019:South Africa; D017282:Tick-Borne Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D014195:Travel
chemical_list: D000900:Anti-Bacterial Agents; D004318:Doxycycline