Relapsing Fever
A Two Thousand Year History
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430 B.C.
The Greek physician Hippocrates accurately described relapsing fever during a 5th century B.C. outbreak on the island of Thasos.
550 A.D.
Following the ravages of the Justinian Plague, a new epidemic occurred throughout the British Isles with various names in different languages that all translated to the Yellow Plague. Based on the symptoms, this plague has been attributed to louse-borne relapsing fever. The Irish annals date it to circa 550 A.D.
1770
In 1770, Dr. John Rutty described the presence of relapsing fever in Dublin, Ireland. This disease persisted in Ireland and later was a significant contributor to the mortality that occurred during the Potato Famine of the 19th century.
1857
David Livingstone, the British physician, missionary and explorer of Africa, connected the tampan tick-bite with transmission of relapsing fever, based on information provided to him from those familiar with the disease.
1866
Physician Otto Obermeier, in 1866, observed the agent of louse-borne relapsing fever in the blood of a feverish patient, and the bacterium disappeared during remittance of the fever. The bacterium Spirillum Obermeieri (subsequently renamed Borrelia recurrentis) would later be named after Obermeier.
1904
In 1904, Ross and Milne, working in Uganda, and Dutton and Todd in the Congo Free State, discovered an agent of relapsing fever and demonstrated its transmission by ticks. Both Dutton (shown) and Todd were accidently infected during their field studies. Dutton maintained a record of his fever temperatures until he died as a result of the infection.
1903-1946
During the first half of the 20th century, major pandemics of relapsing fever infect over 60 million people with over 5 million deaths.
1982
Dr. Willy Burgdorfer and colleagues report the identification of the agent of Lyme disease, a new Borrelia species subsequently named B. burgdorferi. The researchers’ foundational experience in relapsing fever studies facilitated the discovery.
2023
Smaller outbreaks still occur throughout Africa, Europe and the United States. New species of relapsing fever Borrelia continue to be discovered.
Acknowledgments
We gratefully acknowledge the graphical talents of Austin Athman for construction of the graphical timeline. PES was supported by the Division of Intramural Research of the National Institute of Allergy and Infectious Diseases, National Institutes of Health.