A labourer living in a mud hut in a forest fringe area of East Africa presents with repeated episodes of high fever separated by afebrile intervals of several days. Blood smear shows spirochaetes. He reports being bitten at night by small soft-bodied arthropods hiding in crevices of the hut walls. Which vector is responsible?

• A Simulium damnosum, a blackfly
• B Haemaphysalis spinigera, a hard tick
• C Phlebotomus papatasi, a sandfly
• D Ornithodoros moubata, a soft tick ✓

Explanation

Tick-borne relapsing fever due to Borrelia duttoni is transmitted by soft ticks of the genus Ornithodoros, which live in crack-and-crevice habitats of traditional dwellings, feed rapidly at night, and maintain infection transovarially. Louse-borne relapsing fever involves Pediculus, not any option here. Haemaphysalis spinigera transmits Kyasanur Forest disease, Phlebotomus papatasi causes sandfly fever, and Simulium transmits onchocerciasis.

Reference: Park's Textbook of Preventive and Social Medicine, 26th ed.

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Written and medically reviewed by the StethoPrep medical team.