Moving on to the next category we’ll start looking at diseases. 

04. DISEASES CONTRACTED DURING TRAVEL (12%)
          Diseases Associated with Vectors
          01. African Tick Bite Fever

• Geographic risk
  • “Travelers to sub-Saharan Africa, parts of the Caribbean, and Oceania (Australia, New Zealand, Melanesia, Micronesia, and Polynesia are at risk for African tick bite fever. You are at higher risk if your travel plans include outdoor activities such as camping, hiking, and game hunting in wooded, brushy, or grassy areas.”¹
• Prevention
  • “Know where to expect ticks. Ticks live in grassy, brushy, or wooded areas, or even on animals. Spending time outside camping, gardening, or hunting could bring you in close contact with ticks. Many people get ticks in their own yard or neighborhood.
• • Treat clothing and gear with products containing 0.5% permethrin. Permethrin can be used to treat boots, clothing and camping gear and remain protective through several washings. Alternatively, you can buy permethrin-treated clothing and gear.
• • Use Environmental Protection Agency (EPA)-registered insect repellents containing DEET, picaridin, IR3535, Oil of Lemon Eucalyptus (OLE), para-menthane-diol (PMD), or 2-undecanone. EPA’s helpful search tool can help you find the product that best suits your needs. Always follow product instructions. Do not use products containing OLE or PMD on children under 3 years old.
• • Avoid contact with ticks. Avoid wooded and brushy areas with high grass and leaf litter. Walk in the center of trails.” ¹
• Transmission
  • “African tick bite fever is a disease caused by a bacteria. You can get infected if you are bitten by an infected tick.”¹
  • “Ticks that are infected with bacteria that cause African tick bite fever are usually most active from November through April.”¹
• Possible symptoms
  • “Symptoms usually appear within two weeks after a tick bite. The first sign is often a red sore that develops a dark crust, called an eschar. Eschars are found at the site of tick bite; multiple eschars may be present if you have multiple tick bites. Later symptoms may include fever, headache, muscle soreness, swollen lymph nodes, and a rash.”¹
• Appropriate referral/triage
• I was able to find that complications and fatal outcomes were rare.  It can be managed effectively with antibiotics, typically doxycycline.² For more information see Table 4: Treatment, complications and outcomes of confirmed cases of Rickettsia africae infection at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8805502/ This contains a lot of good information although probably much more than is needed for the exam.

1. Centers for Disease Control and Prevention. (n.d.). African tick bite fever. Centers for Disease Control and Prevention. https://wwwnc.cdc.gov/travel/diseases/african-tick-bite-fever

2. Silva-Ramos, C. R., & Faccini-Martínez, Á. A. (2021, September 10). Clinical, epidemiological, and laboratory features of rickettsia africae infection, African tick-bite fever: A systematic review. Le infezioni in medicina. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8805502/