| Feature |
🪳 Louse-Borne (B. recurrentis) |
🦟 Tick-Borne (B. duttonii & others) |
| Reservoir |
Humans only 👤 |
Rodents 🐭 (except East Africa: humans) |
| Vector |
Body louse (Pediculus humanus) |
Soft tick (Ornithodoros spp.) |
| Transmission |
Via crushed louse → inoculation into skin |
Via tick saliva during feeding |
| Geography |
Africa (Ethiopia, Sudan), refugee/war settings 🌍 |
Africa, Asia, Americas (endemic rural areas) |
| Incubation |
5–15 days |
5–15 days |
| Relapses |
Usually 1–2 relapses 🔁 |
Multiple relapses (up to 10) |
| Severity |
Often more severe; higher mortality ⚠️ |
Usually milder but prolonged |
| Complications |
Myocarditis, meningoencephalitis, jaundice |
Hepatosplenomegaly, CNS involvement, bleeding |
| Treatment |
Tetracycline, Doxycycline, or Penicillin |
Tetracycline or Doxycycline; Erythromycin if pregnant/children |
| Jarisch–Herxheimer Reaction |
Very common (up to 80%) ⚡ |
Also occurs but less frequent |
| Prevention |
Delousing, improved hygiene 🚿 |
Vector control, housing improvement, rodent control 🛡️ |