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Tick Bite Fever

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A few days after your return from savage Africa you start complaining of fever and severe headache. You become confused and your wife insists that you be admitted to hospital. You have abnormally low blood pressure , have fever and have a rash that is covered with small bumps that touch each other in places. Some of your lymph nodes are swollen.

4-5% of Overseas hunters get this disease - and if your doctor does not identify Tick Bite Fever, you may be a few days away from multi-organ failure and death.

Although this is an extreme situation, it is wise to be careful.


Tick bite fever is an infection caused by bacteria which are transmitted by infected ticks to humans in their saliva when they bite. The bacteria can also infect through small skin abrasions when the tick is crushed on your skin. Bacteria are passed from the infected tick to her eggs, thus propogating the infection in her offspring. The Rickettsial bacteria are not able to survive outside of living cells.

Tick bites most often occur when hunting or hiking in the bushveld, particularly where there is long grass.

Hardticks, which have life cycles that involve dogs, rodents or other animals are the hosts of the bacteria. Amblyomma ticks will actively seek out humans on which to feed, while Rhipicephalus ticks tend to lie in wait on grass and grab you with their tiny claws when you brush past.

In South Africa, the cause of tick bite fever is either R. conorii (as in the table), or R. africae.


Typical features include the presence of a black mark at the site of the bite, The blackened bite mark is called an eschar. It looks like a small ulcer (2-5mm in diameter) with a black center, similar to a spider bite. The bite site may be difficult to find with the eschar appearing once the other symptoms begin.

A rash is not always present but when it does occur, it consists of small red marks on the skin, raised slightly above the skin’s surface. It will typically start on the arms and legs, spreading to the abdomen and if severe, even to the palms and soles.

African tick bite fever is usually mild and serious complications and death are rare. Rocky Mountain Spotted Fever is more severe with a death rate of up to 25% if left untreated.


© David Scharf / Science Faction / Corbis

If shortly after your safari you have a severe headache, fever, swollen lymph nodes and feel really ill a week or so, suspect tick bite fever, especially if the area is a known tick bite fever area.

The presence of the bite mark or rash is a strong diagnostic sign. Blood tests will confirm the presence of antibodies produced by your immune response cells in reaction to the infection. But, the antibodies may only show up after a few weeks.

In most cases you will get better in about two weeks without treatment. Treatment with the antibiotic doxycycline can shorten the duration of symptoms and reduce the chance of developing a serious complication. Chloramphenicol may be used. There is no vaccine against tick bite fever.

The incubation period (time from the infected bite to the appearance of symptoms) is 5-7 days.


Some forms of tick bite fever are fairly mild and self-limiting – people may get better on their own without specific treatment. This can take about two weeks. Treatment with an antibiotic can shorten the duration of symptoms and reduce the chance of a serious side-effect.

In severe cases, antibiotic therapy is more important, and can be life saving. The antibiotic doxycycline is the preferred agent for treating tick bite fever. Some people are not able to take doxcycline, in which case chloramphenicol, or sometimes ciprofloxacin, may be used instead.

There is no vaccine against tick bite fever, and taking prophylactic antibiotics (as one does for malaria) has never been shown to be effective or necessary.


Mitch Mitchell is a bow hunter, outdoorsman and the author of several books on African wildlife and survival

As with most things, prevention is better than cure - and early diagnosis speeds recovery.

  • AVOID TICK BITES Wear long sleeved shirts, long pants and shoes. Apply an insect repellent to exposed skin.

  • EARLY DIAGNOSIS If you’ve been in a known tick bite fever area and are suffering from a fever, headache, swollen lymph nodes and have located the eschar (bite mark), seek medical attention.
    The eschar is not always visible so don’t rely on its presence as a diagnostic sign.

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• Scorpions •
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• Heat stroke •
• Tick Bite Fever •
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•  •

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