Box 2: Differential diagnosis of relapsing fevers13
DiseasePathogenAreas of endemicity
Viruses
 Colorado tick feverColorado tick fever virusNorth America
 Yellow feverYellow fever virusSouth America, Africa
 Dengue feverDengue virusSouth or southeast Asia, South or Central America, Caribbean, Africa
 African hemorrhagic feversLassa virus, Marburg virus, Ebola virus, etc.Africa
 Lymphocytic choriomeningitisLymphocytic choriomeningitis mammarenavirusWidespread
 Viral hepatitisHepatitis A – E virusesWidespread
Bacteria
 BrucellosisBrucella speciesWidespread
 LeptospirosisLeptospira speciesWidespread, especially in tropical or subtropical areas
 Rat-bite feverStreptobacillus moniliformis, Spirillum minusPredominantly North America, Asia
 BartonellosisBartonella speciesWidespread
 Typhoid feverSalmonella enterica serovar Typhi or ParatyphiPredominantly south or southeast Asia, southern Africa
 EhrlichiosisEhrlichia speciesNorth America
 RickettsiosisRickettsia speciesWidespread
 TularemiaFrancisella tularensisNorth America, Europe, Asia
 MeningococcemiaNeisseria meningitidisWidespread, but predominantly in sub-Saharan Africa (“meningitis belt”)
Protozoa
 MalariaPlasmodium speciesAfrica, Asia, South America
 BabesiosisBabesia speciesNorth America, Europe, Asia
 Visceral leishmaniasis (kala-azar)Leishmania speciesAfrica, Asia, south or central America, Europe (Mediterranean)