title: Louse-borne relapsing fever in Finland in two asylum seekers from Somalia.
abstract: We report two cases of louse-borne relapsing fever (LBRF) in young Somali asylum seekers having recently arrived to Finland. They had sought medical attention for a febrile illness. Blood smears were examined for suspected malaria, but instead, spirochete shaped bacteria were observed. The bacteria were confirmed as Borrelia recurrentis by PCR and sequencing. The patients survived, but their treatment was complicated by Jarisch-Herxheimer reaction. We conclude that LBRF must be considered as a diagnostic option in febrile refugees also in the northernmost parts of Europe.
authors.affiliation: Department of Medical Microbiology and Immunology, University of Turku, Turku, Finland.|Microbiology and Genetics Department, Turku University Hospital, Turku, Finland.
authors.forename: Jukka
authors.initials: J
authors.lastname: Hytönen
authors.affiliation: Helsinki University Central Hospital, Helsinki, Finland.
authors.forename: Tamim
authors.initials: T
authors.lastname: Khawaja
authors.affiliation: Microbiology and Genetics Department, Turku University Hospital, Turku, Finland.
authors.forename: Juha O
authors.initials: JO
authors.lastname: Grönroos
authors.affiliation: Department of Bacteriology and Immunology, Haartman Institute, Helsinki, Finland.
authors.forename: Anna
authors.initials: A
authors.lastname: Jalava
authors.affiliation: Department of Bacteriology and Immunology, Haartman Institute, Helsinki, Finland.|Immunobiology Research Program, University of Helsinki, Helsinki, Finland.|HUSLAB, Helsinki, Finland.
authors.forename: Seppo
authors.initials: S
authors.lastname: Meri
authors.affiliation: University of Turku and Turku University Hospital, Turku, Finland.
authors.forename: Jarmo
authors.initials: J
authors.lastname: Oksi
mesh_terms: D000328:Adult; D000818:Animals; D001769:Blood / Q000382:microbiology; D001898:Borrelia / Q000302:isolation & purification*; D005387:Finland; D006801:Humans; D010373:Lice Infestations / Q000150:complications*; D008297:Male; D016133:Polymerase Chain Reaction; D012036:Refugees; D012061:Relapsing Fever / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D017422:Sequence Analysis, DNA; D012998:Somalia; D016896:Treatment Outcome
keywords: Borrelia recurrentis; Louse-borne relapsing fever; refugee