Actions if you suspect relapsing fever
The similarity between the clinical manifestations of malaria and RF mean that you should first consider whether a diagnosis of malaria can be ruled out. If your community is in a malaria-endemic area, perform a malaria rapid diagnostic test (RDT) on the patient's blood. If there is no malaria in your area, or the RDT is negative, you should immediately refer a patient suspected of having RF to the nearest higher health facility or hospital.
The good news is that RF can be easily and successfully treated with special antibiotics, but these can only be prescribed by a doctor. You are not expected to prescribe drugs for relapsing fever. The symptoms usually begin to improve within 24 hours of starting the treatment. Make sure that the patient and the family know that RF can be life-threatening without treatment, but that it can be cured with the right medicine.
Lice carrying the bacteria that cause RF are very easily transmitted between close contacts of the infected person. Therefore, you should also do active case finding – searching actively for other cases of RF by asking about anyone with the characteristic symptoms in the patient's family or village to detect if there could be an epidemic spreading. Precautions should be taken by you and by health professionals in the higher health facilities, to avoid close contact with a patient with relapsing fever, to prevent acquiring the infection.