[Rickettsia africae infection among participants in a women's safari to South Africa].

PREFACE: In recent years infections with Rickettsia africae (African tick bite fever) have become a common and important cause of febrile illness among travelers returning from Sub-Saharan Africa, primarily from South Africa.

METHODS: A prospective observational study, involving 671 participants in safaris to South Africa during 2008.

RESULTS: Nine participants (1.34%) were diagnosed with African tick bite fever. The symptoms included fever, headache, muscle pain, lymphadenopathy, vesicular rash, and an eschar. Lack of familiarity with the disease led to an incorrect diagnosis and delayed treatment with doxycycline in a number of cases.

CONCLUSIONS: African tick bite fever is frequent among Israeli travelers to Sub-Saharan Africa. Travelers should be counseled on tick bite prevention. Increased awareness of the disease among Israeli physicians may prevent diagnostic delays.