Fig 1.
Assumed global distribution of TBRF and LBRF (1950–1969) [25].
LBRF, louse-borne relapsing fever; TBRF, tick-borne relapsing fever.
Fig 2.
Microscopic detection of B. recurrentis in blood films.
a) Drawing of B. recurrentis spirochetes found in a thin blood film obtained from a patient suffering from LBRF in 1909 in Jaipur, India [39]. b) Photography of B. recurrentis spirochetes found in a thin blood smear (May–Grünwald–Giemsa stain, magnification 1,000-fold) obtained from an Eritrean migrant suffering from LBRF in 2015 in Basel, Switzerland. LBRF, louse-borne relapsing fever; TBRF, tick-borne relapsing fever. Image credit: Dr. Michael Osthoff.
Table 1.
Overview on laboratory methods applied in LBRF and their advantages, disadvantages, and use.
Table 2.
Diagnostic grading system to judge the certainty of the correct diagnosis of LBRF.
Fig 3.
Flow diagram of search and selection of eligible publications.
LBRF, louse-borne relapsing fever.
Table 3.
Number of diagnosed LBRF cases over time according to the diagnostic method used.
Fig 4.
Geographic visualization of all identified LBRF cases published from 1907 to 2019.
Each data point on the map corresponds to one of the analyzed 184 publications. If 2 or more studies reported cases from the same location, the dots representing these studies are connected by a circle with its center corresponding to this location. LBRF, louse-borne relapsing fever; PCR, polymerase chain reaction. (Map data: Natural Earth).
Table 4.
Publications reporting indirect evidence for the presence of LBRF.
Table 5.
Imported cases of LBRF reported from America, Asia, the Middle East, and Africa.
Table 6.
Imported cases of LBRF reported from Europe.
Table 7.
Reports on LBRF from Latin America.
Table 8.
Reports on LBRF from Northern America.
Table 9.
Reports on LBRF from China.
Table 10.
Reports on LBRF from Korea and Japan.
Table 11.
Reports on LBRF from Southeast Asia.
Table 12.
Reports on LBRF from the Indian subcontinent.
Table 13.
Reports on LBRF from the Middle East and Afghanistan.
Fig 5.
Number of published LBRF cases in relation to the number of publications.
For better visualization, the number of publications is multiplied by 100. The red arrow depicts the trendline of publications reporting imported cases of LBRF. LBRF, louse-borne relapsing fever.
Table 14.
Milestones in microscopy.
Table 15.
Milestones in serology.
Table 16.
Milestones in PCR.
Table 17.
Milestones in animal inoculation and culture.