In Blue Dragonfly, Pedí discovers a mushroom, his nanimoha, that acts like an antibiotic, something no healer in his world has ever had. He uses it to treat the people of Itatu, who are dying from an epidemic of Winter Fever, as they call it. Winter fever is like Relapsing Fever of our world. 

Relapsing Fever is caused by a spirochete bacteria, Borrelia recurrentis, which is spread by lice. The name of the disease comes from its pattern. Patients may have recurrent bouts of fever, up to four or more. Between the fever episodes, the patient feels somewhat better. The first attack is usually the worst and the one where a patient may die. 

In the past, there have been worldwide epidemics caused by this bacteria. The disease is endemic in Ethiopia, with about 10,000 cases occurring each year. The country of Itatu, from my book, is similar to Ethiopia in that it is near the equator but high in elevation.

The disease can be very deadly, but it is one of the few bacterial diseases in which a single dose of an antibiotic will cure the patient. Pedí’s nanimoha mushroom acted the same way. For most diseases he treated, Pedí had to use multiple doses over several days. But a single dose was enough for the Winter Fever of the Itatu.

In a patient with relapsing fever, when the Borrelia bacteria die after treatment, they often cause a reaction in the body called the Jarisch-Herxheimer reaction. The temperature rises, and the blood pressure drops. The patient feels near death, but then the fever breaks and the person recovers. I showed this reaction in the little Itatu girl Pedí treated at Poor Man’s Field.

On a medical humanitarian trip to Ethiopia, I cared for a man who likely had Relapsing Fever. Our makeshift lab where we worked could not test for bacteria, so we had to make the diagnosis based on symptoms. The man was brought to us on the back of a donkey. He was strapped to it so he wouldn’t fall off. His friend cut him free and rolled him onto the ground. The ill man had a high fever and was barely responsive. 

We treated him with a single dose of doxycycline, an antibiotic used for relapsing fever, and then gave him several liters of IV fluid while he lay semi-conscious in a tent. After about four hours, the man woke up, pulled his IV line out, then went to urinate in the bushes nearby. He got on his donkey and rode away.