Acute Respiratory Distress Syndrome in Persons With Tickborne Relapsing Fever—Three States, 2004-2005

Tickborne relapsing fever (TBRF) is a bacterial illness caused by certain species of Borrelia and transmitted through brief and painless bites from Ornithodoros sticks. Here, Murphy et al report three cases of severe TBRF and the results of the subsequent epidemiologic investigations. The findings indicate the acute respiratory distress syndrome might occur more frequently in patients with TBRF than previously recognized. Optimal management of TBRF requires both prompt diagnosis and careful observation during the initial phases of treatment. A CDC editorial note is included.