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In North America, tickborne relapsing fever (TBRF) is most commonly caused by Borrelia hermsii spirochetes that are transmitted from rodent reservoirs to humans by Ornithodoros hermsii ticks during 15- to 90-minute feeds. The infection is characterized by recurrent episodes of fever, myalgia, arthralgia, headache, and nausea after an incubation period of several days. Between 1982 and 2013, the number of cases reported in Arizona each year was zero to three.
On August 10, 2014, Arizona health officials were notified by a hospital that five high school students who had attended an outdoor educational camp had been admitted for fever, headache, and myalgias. Although Hantavirus infection was suspected, blood smears from all five patients revea…