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Jaenson TGT, Gray JS, Lindgren PE, Wilhelmsson P. Coinfection of Babesia and Borrelia in the Tick Ixodes ricinus-A Neglected Public Health Issue in Europe? Pathogens 2024; 13:81. [PMID: 38251388 PMCID: PMC10818971 DOI: 10.3390/pathogens13010081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 01/09/2024] [Accepted: 01/15/2024] [Indexed: 01/23/2024] Open
Abstract
Ixodes ricinus nymphs and adults removed from humans, and larvae and nymphs from birds, have been analysed for infection with Babesia species and Borrelia species previously in separately published studies. Here, we use the same data set to explore the coinfection pattern of Babesia and Borrelia species in the ticks. We also provide an overview of the ecology and potential public health importance in Sweden of I. ricinus infected both with zoonotic Babesia and Borrelia species. Among 1952 nymphs and adult ticks removed from humans, 3.1% were PCR-positive for Babesia spp. Of these Babesia-positive ticks, 43% were simultaneously Borrelia-positive. Among 1046 immatures of I. ricinus removed from birds, 2.5% were Babesia-positive, of which 38% were coinfected with Borrelia species. This study shows that in I. ricinus infesting humans or birds in Sweden, potentially zoonotic Babesia protozoa sometimes co-occur with human-pathogenic Borrelia spp. Diagnostic tests for Babesia spp. infection are rarely performed in Europe, and the medical significance of this pathogen in Europe could be underestimated.
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Affiliation(s)
- Thomas G. T. Jaenson
- Evolutionary Biology Centre, Department of Organismal Biology, Uppsala University, Norbyvägen 18d, SE-752 36 Uppsala, Sweden;
| | - Jeremy S. Gray
- UCD School of Biology and Environmental Science, University College Dublin, D04 N2E5 Dublin, Ireland;
| | - Per-Eric Lindgren
- Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Linköping University, SE-581 83 Linköping, Sweden;
- Department of Clinical Microbiology, Region Jönköping County, SE-551 11 Jönköping, Sweden
| | - Peter Wilhelmsson
- Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Linköping University, SE-581 83 Linköping, Sweden;
- Department of Clinical Microbiology, Region Jönköping County, SE-551 11 Jönköping, Sweden
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Burde J, Bloch EM, Kelly JR, Krause PJ. Human Borrelia miyamotoi Infection in North America. Pathogens 2023; 12:553. [PMID: 37111439 PMCID: PMC10145171 DOI: 10.3390/pathogens12040553] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/27/2023] [Accepted: 03/29/2023] [Indexed: 04/05/2023] Open
Abstract
Borrelia miyamotoi is an emerging pathogen that causes a febrile illness and is transmitted by the same hard-bodied (ixodid) ticks that transmit several other pathogens, including Borrelia species that cause Lyme disease. B. miyamotoi was discovered in 1994 in Ixodes persulcatus ticks in Japan. It was first reported in humans in 2011 in Russia. It has subsequently been reported in North America, Europe, and Asia. B. miyamotoi infection is widespread in Ixodes ticks in the northeastern, northern Midwestern, and far western United States and in Canada. In endemic areas, human B. miyamotoi seroprevalence averages from 1 to 3% of the population, compared with 15 to 20% for B. burgdorferi. The most common clinical manifestations of B. miyamotoi infection are fever, fatigue, headache, chills, myalgia, arthralgia, and nausea. Complications include relapsing fever and rarely, meningoencephalitis. Because clinical manifestations are nonspecific, diagnosis requires laboratory confirmation by PCR or blood smear examination. Antibiotics are effective in clearing infection and are the same as those used for Lyme disease, including doxycycline, tetracycline, erythromycin, penicillin, and ceftriaxone. Preventive measures include avoiding areas where B. miyamotoi-infected ticks are found, landscape management, and personal protective strategies such as protective clothing, use of acaricides, and tick checks with rapid removal of embedded ticks.
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Affiliation(s)
- Jed Burde
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT 06520, USA
| | - Evan M. Bloch
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University, Baltimore, MD 21217, USA
| | - Jill R. Kelly
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT 06520, USA
| | - Peter J. Krause
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT 06520, USA
- Department of Medicine, Yale School of Medicine, New Haven, CT 06510, USA
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Armstrong BA, Brandt KS, Goodrich I, Gilmore RD. Evaluation of Immunocompetent Mouse Models for Borrelia miyamotoi Infection. Microbiol Spectr 2023; 11:e0430122. [PMID: 36715531 PMCID: PMC10100797 DOI: 10.1128/spectrum.04301-22] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 01/10/2023] [Indexed: 01/31/2023] Open
Abstract
Borrelia miyamotoi is a relapsing fever spirochete that is harbored by Ixodes spp. ticks and is virtually uncharacterized, compared to other relapsing fever Borrelia vectored by Ornithodoros spp. ticks. There is not an immunocompetent mouse model for studying B. miyamotoi infection in vivo or for transmission in the vector-host cycle. Our goal was to evaluate B. miyamotoi infections in multiple mouse breeds/strains as a prelude to the ascertainment of the best experimental infection model. Two B. miyamotoi strains, namely, LB-2001 and CT13-2396, as well as three mouse models, namely, CD-1, C3H/HeJ, and BALB/c, were evaluated. We were unable to observe B. miyamotoi LB-2001 spirochetes in the blood via darkfield microscopy or to detect DNA via real-time PCR post needle inoculation in the CD-1 and C3H/HeJ mice. However, LB-2001 DNA was detected via real-time PCR in the blood of the BALB/c mice after needle inoculation, although spirochetes were not observed via microscopy. CD-1, C3H/HeJ, and BALB/c mice generated an antibody response to B. miyamotoi LB-2001 following needle inoculation, but established infections were not detected, and the I. scapularis larvae failed to acquire spirochetes from the exposed CD-1 mice. In contrast, B. miyamotoi CT13-2396 was visualized in the blood of the CD-1 and C3H/HeJ mice via darkfield microscopy and detected by real-time PCR post needle inoculation. Both mouse strains seroconverted. However, no established infection was detected in the mouse organs, and the I. scapularis larvae failed to acquire Borrelia after feeding on CT13-2396 exposed CD-1 or C3H/HeJ mice. These findings underscore the challenges in establishing an experimental B. miyamotoi infection model in immunocompetent laboratory mice. IMPORTANCE Borrelia miyamotoi is a causative agent of hard tick relapsing fever, was first identified in the early 1990s, and was characterized as a human pathogen in 2011. Unlike other relapsing fever Borrelia species, B. miyamotoi spread by means of Ixodes ticks. The relatively recent recognition of this human pathogen means that B. miyamotoi is virtually uncharacterized, compared to other Borrelia species. Currently there is no standard mouse-tick model with which to study the interactions of the pathogen within its vector and hosts. We evaluated two B. miyamotoi isolates and three immunocompetent mouse models to identify an appropriate model with which to study tick-host-pathogen interactions. With the increased prevalence of human exposure to Ixodes ticks, having an appropriate model with which to study B. miyamotoi will be critical for the future development of diagnostics and intervention strategies.
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Affiliation(s)
- Brittany A. Armstrong
- Bacterial Diseases Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Kevin S. Brandt
- Bacterial Diseases Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Irina Goodrich
- Bacterial Diseases Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Robert D. Gilmore
- Bacterial Diseases Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
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Baneth G, Dvorkin A, Ben-Shitrit B, Kleinerman G, Salant H, Straubinger RK, Nachum-Biala Y. Infection and seroprevalence of Borrelia persica in domestic cats and dogs in Israel. Parasit Vectors 2022; 15:102. [PMID: 35534871 PMCID: PMC9087918 DOI: 10.1186/s13071-022-05223-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 02/24/2022] [Indexed: 11/12/2022] Open
Abstract
Background Relapsing fever borreliosis is an infectious disease caused by bacteria of the genus Borrelia, inflicting recurrent episodes of fever and spirochetemia in humans. Borrelia persica, the causative agent of relapsing fever in Israel, is prevalent over a broad geographic area that extends from India to Egypt. It is transmitted by the soft tick Ornithodoros tholozani and causes disease in humans as well as domestic cats and dogs. The goal of this study was to survey domestic dogs and cats in Israel for infection with B. persica. Methods Blood, sera and demographic and clinical data were collected from dogs and cats brought for veterinary care in central Israel. PCR followed by DNA sequencing was used to detect B. persica DNA in blood samples, and an enzyme-linked immunosorbent assay (ELISA) was used to detect antibodies reactive with B. persica antigens in sera from the same animals. This is the first serological survey of B. persica in dogs and the first survey for antibodies reactive with a relapsing fever Borrelia sp. in cats globally. Results Four of the 208 dogs (1.9%) and three of 103 cats (2.9%) sampled were positive by PCR for B. persica DNA, and 24 dogs (11.5%) and 18 cats (17.5%) were seropositive for B. persica antigen by ELISA. The ratio between PCR-positivity and seropositivity in both the dog and cat populations was 1:6. All four PCR-positive dogs and two of three PCR-positive cats were seronegative, suggesting a probable recent infection. Thrombocytopenia showed significant association with seropositivity in dogs (P = 0.003). In cats, anemia had a significant association with seropositivity (P = 0.0001), and thrombocytopenia was associated with the combined prevalence of seropositivity or PCR-positivity (P = 0.022). Conclusions Borrelia persica infection is more prevalent and widespread in domestic canine and feline populations in Israel than previously thought. Dogs and cats may play a role as reservoirs and sentinels for human infection. Precautions should be taken to prevent transfusion-transmitted infection between blood donor and recipient animals. Graphic Abstract ![]()
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Affiliation(s)
- Gad Baneth
- The Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, P.O. Box 12, 761001, Rehovot, Israel.
| | - Ann Dvorkin
- The Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, P.O. Box 12, 761001, Rehovot, Israel
| | - Bar Ben-Shitrit
- The Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, P.O. Box 12, 761001, Rehovot, Israel
| | - Gabriela Kleinerman
- The Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, P.O. Box 12, 761001, Rehovot, Israel
| | - Harold Salant
- The Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, P.O. Box 12, 761001, Rehovot, Israel
| | - Reinhard K Straubinger
- Bacteriology and Mycology, Institute for Infectious Diseases and Zoonoses, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Yaarit Nachum-Biala
- The Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, P.O. Box 12, 761001, Rehovot, Israel
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Johnston D, Kelly JR, Ledizet M, Lavoie N, Smith RP, Parsonnet J, Schwab J, Stratidis J, Espich S, Lee G, Maciejewski KR, Deng Y, Majam V, Zheng H, Bonkoungou SN, Stevens J, Kumar S, Krause PJ. Frequency and Geographic Distribution of Borrelia miyamotoi, Borrelia burgdorferi, and Babesia microti Infections in New England Residents. Clin Infect Dis 2022:ciac107. [PMID: 35325084 DOI: 10.1093/cid/ciac107] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Borrelia miyamotoi is a relapsing fever spirochete that relatively recently has been reported to infect humans. It causes an acute undifferentiated febrile illness that can include meningoencephalitis and relapsing fever. Like Borrelia burgdorferi, it is transmitted by Ixodes scapularis ticks in the northeastern United States and by Ixodes pacificus ticks in the western United States. Despite reports of clinical cases from North America, Europe, and Asia, the prevalence, geographic range, and pattern of expansion of human B. miyamotoi infection are uncertain. To better understand these characteristics of B. miyamotoi in relation to other tickborne infections, we carried out a cross-sectional seroprevalence study across New England that surveyed B. miyamotoi, B. burgdorferi, and Babesia microti infections. METHODS We measured specific antibodies against B. miyamotoi, B. burgdorferi, and B. microti among individuals living in 5 New England states in 2018. RESULTS Analysis of 1153 serum samples collected at 11 catchment sites showed that the average seroprevalence for B. miyamotoi was 2.8% (range, 0.6%-5.2%), which was less than that of B. burgdorferi (11.0%; range, 6.8%-15.6%) and B. microti (10.0%; range, 6.5%-13.6%). Antibody screening within county residence in New England showed varying levels of seroprevalence for these pathogens but did not reveal a vectoral geographical pattern of distribution. CONCLUSIONS Human infections caused by B. miyamotoi, B. burgdorferi, and B. microti are widespread with varying prevalence throughout New England.
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Affiliation(s)
- Demerise Johnston
- Yale School of Public Health, Department of Epidemiology of Microbial Diseases and Yale School of Medicine, New Haven, Connecticut, USA
- US Food and Drug Administration, Laboratory of Emerging Pathogens, Silver Spring, Maryland, USA
| | - Jill R Kelly
- Yale School of Public Health, Department of Epidemiology of Microbial Diseases and Yale School of Medicine, New Haven, Connecticut, USA
| | | | | | | | | | - Jonathan Schwab
- Northampton Area Pediatrics, Northampton, Massachusetts, USA
| | | | - Scott Espich
- Yale School of Public Health, Department of Epidemiology of Microbial Diseases and Yale School of Medicine, New Haven, Connecticut, USA
| | - Giyoung Lee
- Yale School of Public Health, Department of Epidemiology of Microbial Diseases and Yale School of Medicine, New Haven, Connecticut, USA
| | - Kaitlin R Maciejewski
- Yale School of Public Health, Department of Epidemiology of Microbial Diseases and Yale School of Medicine, New Haven, Connecticut, USA
| | - Yanhong Deng
- Yale School of Public Health, Department of Epidemiology of Microbial Diseases and Yale School of Medicine, New Haven, Connecticut, USA
| | - Victoria Majam
- US Food and Drug Administration, Laboratory of Emerging Pathogens, Silver Spring, Maryland, USA
| | - Hong Zheng
- US Food and Drug Administration, Laboratory of Emerging Pathogens, Silver Spring, Maryland, USA
| | - Sougr-Nooma Bonkoungou
- US Food and Drug Administration, Laboratory of Emerging Pathogens, Silver Spring, Maryland, USA
| | - June Stevens
- Yale New Haven Hospital, Department of Laboratory Medicine, New Haven, Connecticut, USA
| | - Sanjai Kumar
- US Food and Drug Administration, Laboratory of Emerging Pathogens, Silver Spring, Maryland, USA
| | - Peter J Krause
- Yale School of Public Health, Department of Epidemiology of Microbial Diseases and Yale School of Medicine, New Haven, Connecticut, USA
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Liang L, Wang J, Schorter L, Nguyen Trong TP, Fell S, Ulrich S, Straubinger RK. Rapid clearance of Borrelia burgdorferi from the blood circulation. Parasit Vectors 2020; 13:191. [PMID: 32312278 PMCID: PMC7171858 DOI: 10.1186/s13071-020-04060-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 04/01/2020] [Indexed: 12/02/2022] Open
Abstract
Background Borrelia burgdorferi is a tick-borne spirochete that causes Lyme borreliosis (LB). After an initial tick bite, it spreads from the deposition site in the dermis to distant tissues of the host. It is generally believed that this spirochete disseminates via the hematogenous route. Borrelia persica causes relapsing fever and is able to replicate in the blood stream. Currently the exact dissemination pathway of LB pathogens in the host is not known and controversially discussed. Methods In this study, we established a strict intravenous infection murine model using host-adapted spirochetes. Survival capacity and infectivity of host-adapted B. burgdorferi sensu stricto (Bbss) were compared to those of B. persica (Bp) after either intradermal (ID) injection into the dorsal skin of immunocompetent mice or strict intravenous (IV) inoculation via the jugular vein. By in vitro culture and PCR, viable spirochetes and their DNA load in peripheral blood were periodically monitored during a 49/50-day course post-injection, as well as in various tissue samples collected at day 49/50. Specific antibodies in individual plasma/serum samples were detected with serological methods. Results Regardless of ID or IV injection, DNA of Bp was present in blood samples up to day 24 post-challenge, while no Bbss was detectable in the blood circulation during the complete observation period. In contrast to the brain tropism of Bp, Bbss spirochetes were found in ear, skin, joint, bladder, and heart tissue samples of only ID-inoculated mice. All tested tissues collected from IV-challenged mice were negative for traces of Bbss. ELISA testing of serum samples showed that Bp induced gradually increasing antibody levels after ID or IV inoculation, while Bbss did so only after ID injection but not after IV inoculation. Conclusions This study allows us to draw the following conclusions: (i) Bp survives in the blood and disseminates to the host’s brain via the hematogenous route; and (ii) Bbss, in contrast, is cleared rapidly from the blood stream and is a tissue-bound spirochete.![]()
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Affiliation(s)
- Liucun Liang
- Bacteriology and Mycology, Institute for Infectious Diseases and Zoonoses, Department of Veterinary Science, Faculty of Veterinary Medicine, LMU Munich, Munich, Germany
| | - Jinyong Wang
- Department of Microbiology & Immunology, Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, USA.,Shenzhen International Institute for Biomedical Research, Shenzhen, Guangdong, People's Republic of China
| | - Lucas Schorter
- Bacteriology and Mycology, Institute for Infectious Diseases and Zoonoses, Department of Veterinary Science, Faculty of Veterinary Medicine, LMU Munich, Munich, Germany
| | - Thu Phong Nguyen Trong
- Bacteriology and Mycology, Institute for Infectious Diseases and Zoonoses, Department of Veterinary Science, Faculty of Veterinary Medicine, LMU Munich, Munich, Germany
| | - Shari Fell
- Bacteriology and Mycology, Institute for Infectious Diseases and Zoonoses, Department of Veterinary Science, Faculty of Veterinary Medicine, LMU Munich, Munich, Germany.,Chemisches Veterinäruntersuchungsamt Sigmaringen, Fidelis-Graf-Straße 1, 72488, Sigmaringen, Germany
| | - Sebastian Ulrich
- Bacteriology and Mycology, Institute for Infectious Diseases and Zoonoses, Department of Veterinary Science, Faculty of Veterinary Medicine, LMU Munich, Munich, Germany
| | - Reinhard K Straubinger
- Bacteriology and Mycology, Institute for Infectious Diseases and Zoonoses, Department of Veterinary Science, Faculty of Veterinary Medicine, LMU Munich, Munich, Germany.
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Lynn GE, Breuner NE, Eisen L, Hojgaard A, Replogle AJ, Eisen RJ. An immunocompromised mouse model to infect Ixodes scapularis ticks with the relapsing fever spirochete, Borrelia miyamotoi. Ticks Tick Borne Dis 2019; 10:352-359. [PMID: 30503357 PMCID: PMC11392017 DOI: 10.1016/j.ttbdis.2018.11.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 11/17/2018] [Accepted: 11/26/2018] [Indexed: 11/28/2022]
Abstract
The hard tick-borne relapsing fever spirochete, Borrelia miyamotoi, has recently gained attention as a cause of human illness, but fundamental aspects of its enzootic maintenance are still poorly understood. Challenges to experimental studies with B. miyamotoi-infected vector ticks include low prevalence of infection in field-collected ticks and seemingly inefficient horizontal transmission from infected immunocompetent rodents to feeding ticks. To reliably produce large numbers of B. miyamotoi-infected ticks in support of experimental studies, we developed an animal model where immunocompromised Mus musculus SCID mice were used as a source of B. miyamotoi-infection for larval and nymphal Ixodes scapularis ticks. Following needle inoculation with 1 × 105 spirochetes, the SCID mice developed a high spirochetemia (greater than 1 × 107 copies of B. miyamotoi purB per mL of blood) that persisted for at least 30 d after inoculation. In comparison, immunocompetent M. musculus CD-1 mice developed transient infections, detectable for only 2-8 d within the first 16 d after needle inoculation, with a brief, lower peak spirochetemia (8.5 × 104 - 5.6 × 105purB copies per mL of blood). All larval or nymphal ticks fed on infected SCID mice acquired B. miyamotoi, but frequent loss of infection during the molt led to the proportion infected ticks of the resulting nymphal or adult stages declining to 22-29%. The ticks that remained infected after the molt had well-disseminated infections which then persisted through successive life stages, including transmission to larval offspring.
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Affiliation(s)
| | | | - Lars Eisen
- Centers for Disease Control and Prevention, United States
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Duncan R, Grigorenko E, Fisher C, Hockman D, Lanning B. Advances in multiplex nucleic acid diagnostics for blood-borne pathogens: promises and pitfalls - an update. Expert Rev Mol Diagn 2018; 19:15-25. [DOI: 10.1080/14737159.2019.1559055] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Robert Duncan
- Center for Biologics Evaluation and Research, US FDA, Silver Spring, MD, USA
| | | | - Carolyn Fisher
- Center for Biologics Evaluation and Research, US FDA, Silver Spring, MD, USA
| | | | - Bryan Lanning
- Center for Biologics Evaluation and Research, US FDA, Silver Spring, MD, USA
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9
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Talagrand-Reboul E, Boyer PH, Bergström S, Vial L, Boulanger N. Relapsing Fevers: Neglected Tick-Borne Diseases. Front Cell Infect Microbiol 2018; 8:98. [PMID: 29670860 PMCID: PMC5893795 DOI: 10.3389/fcimb.2018.00098] [Citation(s) in RCA: 102] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 03/16/2018] [Indexed: 11/13/2022] Open
Abstract
Relapsing fever still remains a neglected disease and little is known on its reservoir, tick vector and physiopathology in the vertebrate host. The disease occurs in temperate as well as tropical countries. Relapsing fever borreliae are spirochaetes, members of the Borreliaceae family which also contain Lyme disease spirochaetes. They are mainly transmitted by Ornithodoros soft ticks, but some species are vectored by ixodid ticks. Traditionally a Borrelia species is associated with a specific vector in a particular geographical area. However, new species are regularly described, and taxonomical uncertainties deserve further investigations to better understand Borrelia vector/host adaptation. The medical importance of Borrelia miyamotoi, transmitted by Ixodes spp., has recently spawned new interest in this bacterial group. In this review, recent data on tick-host-pathogen interactions for tick-borne relapsing fevers is presented, with special focus on B. miyamotoi.
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Affiliation(s)
- Emilie Talagrand-Reboul
- Early Bacterial Virulence: Borrelia Group, Université de Strasbourg, Facultés de Médecine et de Pharmacie, CHRU Strasbourg, Fédération de Médecine Translationnelle de Strasbourg, VBB EA 7290, Strasbourg, France
| | - Pierre H. Boyer
- Early Bacterial Virulence: Borrelia Group, Université de Strasbourg, Facultés de Médecine et de Pharmacie, CHRU Strasbourg, Fédération de Médecine Translationnelle de Strasbourg, VBB EA 7290, Strasbourg, France
| | - Sven Bergström
- Department of Molecular Biology, Umeå University, Umeå, Sweden
- Laboratory for Molecular Infection Medicine Sweden, Umeå University, Umeå, Sweden
| | - Laurence Vial
- CIRAD BIOS, UMR15 CIRAD/Institut National de la Recherche Agronomique “Contrôle des Maladies Animales Exotiques et Emergentes,” Equipe “Vecteurs,” Campus International de Baillarguet, Montpellier, France
| | - Nathalie Boulanger
- Early Bacterial Virulence: Borrelia Group, Université de Strasbourg, Facultés de Médecine et de Pharmacie, CHRU Strasbourg, Fédération de Médecine Translationnelle de Strasbourg, VBB EA 7290, Strasbourg, France
- Centre National de Référence Borrelia, Centre Hospitalier Universitaire, Strasbourg, France
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10
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Kadkhoda K, Dumouchel C, Brancato J, Gretchen A, Krause PJ. Human seroprevalence of Borrelia miyamotoi in Manitoba, Canada, in 2011-2014: a cross-sectional study. CMAJ Open 2017; 5:E690-E693. [PMID: 28882852 PMCID: PMC5621960 DOI: 10.9778/cmajo.20170070] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Hard tick-borne relapsing fever caused by Borrelia miyamotoi has been reported in Russia, the Netherlands, Germany, Japan and the northeastern and upper midwestern United States. We sought to investigate the presence of B. miyamotoi infection in humans in Manitoba, Canada. METHODS Two hundred fifty sera collected from residents of Manitoba with suspected Lyme disease between 2011 and 2014 were tested for Borrelia burgdorferi antibody using a C6 peptide enzyme-linked immunosorbent assay (ELISA) followed by Western blot. Residual sera were then anonymized, stored at -80°C and subsequently thawed and tested for B. miyamotoi antibody using a 2-step glycerosphosphodiester phosphodiesterase-based ELISA and Western blot assay. RESULTS Twenty-four of the 250 (9.6%) sera tested positive for B. miyamotoi immunoglobulin G. Participants who were B. miyamotoi seropositive were predominantly male (54%) and younger on average than those who were seronegative (32 and 44 yr of age, respectively). Participants who were seropositive for B. burgdorferi were significantly more likely to be B. miyamotoi seropositive than those who were B. burgdorferi seronegative (20.3% v. 6.6%, respectively, odds ratio 3.6, 95% confidence interval 1.5-8.5). INTERPRETATION This initial report of human B. miyamotoi infection in Canada should raise awareness of hard tick-borne relapsing fever among clinicians and residents of areas in Canada and western North America where Lyme disease is endemic.
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Affiliation(s)
- Kamran Kadkhoda
- Affiliations: Cadham Provincial Laboratory (Kadkhoda, Gretchen); Departments of Medical Microbiology & Infectious Diseases and Immunology (Kadkhoda), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Yale School of Public Health (Dumouchel, Brancato, Krause); Yale School of Medicine (Krause), New Haven, CT
| | - Cecilia Dumouchel
- Affiliations: Cadham Provincial Laboratory (Kadkhoda, Gretchen); Departments of Medical Microbiology & Infectious Diseases and Immunology (Kadkhoda), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Yale School of Public Health (Dumouchel, Brancato, Krause); Yale School of Medicine (Krause), New Haven, CT
| | - Janna Brancato
- Affiliations: Cadham Provincial Laboratory (Kadkhoda, Gretchen); Departments of Medical Microbiology & Infectious Diseases and Immunology (Kadkhoda), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Yale School of Public Health (Dumouchel, Brancato, Krause); Yale School of Medicine (Krause), New Haven, CT
| | - Ainsley Gretchen
- Affiliations: Cadham Provincial Laboratory (Kadkhoda, Gretchen); Departments of Medical Microbiology & Infectious Diseases and Immunology (Kadkhoda), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Yale School of Public Health (Dumouchel, Brancato, Krause); Yale School of Medicine (Krause), New Haven, CT
| | - Peter J Krause
- Affiliations: Cadham Provincial Laboratory (Kadkhoda, Gretchen); Departments of Medical Microbiology & Infectious Diseases and Immunology (Kadkhoda), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Yale School of Public Health (Dumouchel, Brancato, Krause); Yale School of Medicine (Krause), New Haven, CT
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11
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Stone BL, Brissette CA. Host Immune Evasion by Lyme and Relapsing Fever Borreliae: Findings to Lead Future Studies for Borrelia miyamotoi. Front Immunol 2017; 8:12. [PMID: 28154563 PMCID: PMC5243832 DOI: 10.3389/fimmu.2017.00012] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 01/05/2017] [Indexed: 12/13/2022] Open
Abstract
The emerging pathogen, Borrelia miyamotoi, is a relapsing fever spirochete vectored by the same species of Ixodes ticks that carry the causative agents of Lyme disease in the US, Europe, and Asia. Symptoms caused by infection with B. miyamotoi are similar to a relapsing fever infection. However, B. miyamotoi has adapted to different vectors and reservoirs, which could result in unique physiology, including immune evasion mechanisms. Lyme Borrelia utilize a combination of Ixodes-produced inhibitors and native proteins [i.e., factor H-binding proteins (FHBPs)/complement regulator-acquiring surface proteins, p43, BBK32, BGA66, BGA71, CD59-like protein] to inhibit complement, while some relapsing fever spirochetes use C4b-binding protein and likely Ornithodoros-produced inhibitors. To evade the humoral response, Borrelia utilize antigenic variation of either outer surface proteins (Osps) and the Vmp-like sequences (Vls) system (Lyme borreliae) or variable membrane proteins (Vmps, relapsing fever borreliae). B. miyamotoi possesses putative FHBPs and antigenic variation of Vmps has been demonstrated. This review summarizes and compares the common mechanisms utilized by Lyme and relapsing fever spirochetes, as well as the current state of understanding immune evasion by B. miyamotoi.
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Affiliation(s)
- Brandee L Stone
- Department of Biomedical Sciences, School of Medicine and Health Sciences, University of North Dakota , Grand Forks, ND , USA
| | - Catherine A Brissette
- Department of Biomedical Sciences, School of Medicine and Health Sciences, University of North Dakota , Grand Forks, ND , USA
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12
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Wagemakers A, Jahfari S, de Wever B, Spanjaard L, Starink MV, de Vries HJC, Sprong H, Hovius JW. Borrelia miyamotoi in vectors and hosts in The Netherlands. Ticks Tick Borne Dis 2016; 8:370-374. [PMID: 28065617 DOI: 10.1016/j.ttbdis.2016.12.012] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 12/23/2016] [Accepted: 12/27/2016] [Indexed: 10/20/2022]
Abstract
Ixodes ticks transmit Borrelia burgdorferi sensu lato (s.l.), the causative agent of Lyme borreliosis (LB). These tick species also transmit Borrelia miyamotoi, which was recently found to cause infections in humans. We were interested in the prevalence of B. miyamotoi infection in ticks and natural hosts in The Netherlands, and to what extent ticks are co-infected with B. burgdorferi. In addition, erythema migrans has been sporadically described in B. miyamotoi-infected patients, but these skin lesions might as well represent co-infections with B. burgdorferi s.l. We therefore investigated whether B. miyamotoi was present in LB-suspected skin lesions of patients referred to our tertiary Lyme disease clinic. 3360 questing Ixodes ricinus nymphs as well as spleen tissue of 74 rodents, 26 birds and 10 deer were tested by PCR for the presence of B. miyamotoi. Tick lysates were also tested for the presence of B. burgdorferi s.l. Next, we performed a PCR for B. miyamotoi in 31 biopsies from LB-suspected skin lesions in patients visiting our tertiary Lyme center. These biopsies had been initially tested for B. burgdorferi s.l. by PCR, and the skin lesions had been investigated by specialized dermatologists. Out of 3360 unfed (or questing) nymphs, 313 (9.3%) were infected with B. burgdorferi s.l., 70 (2.1%) were infected with B. miyamotoi, and 14 (0.4%) were co-infected with B. burgdorferi s.l. and B. miyamotoi. Co-infection of B. burgdorferi s.l. with B. miyamotoi occurred more often than expected from single infection prevalences (p=0.03). Both rodents (9%) and birds (8%) were found positive for B. miyamotoi by PCR, whereas the roe deer samples were negative. Out of 31 LB-suspected skin biopsies, 10 (32%) were positive for B. burgdorferi s.l. while none were positive for B. miyamotoi. The significant association of B. burgdorferi s.l. with B. miyamotoi in nymphs implies the existence of mutual reservoir hosts. Indeed, the presence of B. miyamotoi DNA indicates systemic infections in birds as well as rodents. However, their relative contributions to the enzootic cycle of B. miyamotoi requires further investigation. We could not retrospectively diagnose B. miyamotoi infection using biopsies of LB-suspected skin lesions, supporting the hypothesis that B. miyamotoi is not associated with LB-associated skin manifestations. However, this warrants further studies in larger sets of skin biopsies. A prospective study focused on acute febrile illness after a tick bite could provide insight into the incidence and clinical manifestations of B. miyamotoi infection in The Netherlands.
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Affiliation(s)
- Alex Wagemakers
- Center for Experimental and Molecular Medicine, Academic Medical Center, Meibergdreef 9, 1105AZ Amsterdam, The Netherlands.
| | - Seta Jahfari
- Center for Infectious Disease Control, Institute for Public Health and Environment, Antonie van Leeuwenhoeklaan 9, 3721 MA Bilthoven, The Netherlands.
| | - Bob de Wever
- Department of Medical Microbiology, Academic Medical Center, Meibergdreef 9, 1105AZ Amsterdam, The Netherlands.
| | - Lodewijk Spanjaard
- Department of Medical Microbiology, Academic Medical Center, Meibergdreef 9, 1105AZ Amsterdam, The Netherlands.
| | - Markus V Starink
- Amsterdam Multidisciplinary Lyme borreliosis Center/Department of Dermatology, Meibergdreef 9, 1105AZ Amsterdam, The Netherlands.
| | - Henry J C de Vries
- Amsterdam Multidisciplinary Lyme borreliosis Center/Department of Dermatology, Meibergdreef 9, 1105AZ Amsterdam, The Netherlands; STI Outpatient Clinic, Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, The Netherlands.
| | - Hein Sprong
- Center for Infectious Disease Control, Institute for Public Health and Environment, Antonie van Leeuwenhoeklaan 9, 3721 MA Bilthoven, The Netherlands.
| | - Joppe W Hovius
- Center for Experimental and Molecular Medicine/Amsterdam Multidisciplinary Lyme borreliosis Center, Academic Medical Center, Meibergdreef 9, 1105AZ Amsterdam, The Netherlands.
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13
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Siński E, Welc-Falęciak R, Zajkowska J. Borrelia miyamotoi: A human tick-borne relapsing fever spirochete in Europe and its potential impact on public health. Adv Med Sci 2016; 61:255-260. [PMID: 27100337 DOI: 10.1016/j.advms.2016.03.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Revised: 02/29/2016] [Accepted: 03/04/2016] [Indexed: 12/25/2022]
Abstract
Borrelia miyamotoi is a tick-borne bacterium which has only recently been identified in Europe as a human pathogen causing relapsing fever and little is known about its local impact on human health. There are three types of B. miyamotoi: Asian (Siberian), European, and American. B. miyamotoi is transmitted by the same Ixodes ricinus-persulcatus species complex, which also transmits B. burgdorferi s.l., the Lyme borreliosis group. Both Borrelia groups are mostly maintained in natural rodent populations. The aim of this review is to summarize the available literature on B. miyamotoi, with the focus of attention falling on Europe, as well as to describe its presence in ticks, reservoir hosts, and humans and discuss its potential impact on public health.
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Wagemakers A, Koetsveld J, Narasimhan S, Wickel M, Deponte K, Bleijlevens B, Jahfari S, Sprong H, Karan LS, Sarksyan DS, van der Poll T, Bockenstedt LK, Bins AD, Platonov AE, Fikrig E, Hovius JW. Variable Major Proteins as Targets for Specific Antibodies against Borrelia miyamotoi. THE JOURNAL OF IMMUNOLOGY 2016; 196:4185-95. [PMID: 27076681 DOI: 10.4049/jimmunol.1600014] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Accepted: 03/13/2016] [Indexed: 11/19/2022]
Abstract
Borrelia miyamotoi is a relapsing fever spirochete in Ixodes ticks that has been recently identified as a human pathogen causing hard tick-borne relapsing fever (HTBRF) across the Northern Hemisphere. No validated serologic test exists, and current serologic assays have low sensitivity in early HTBRF. To examine the humoral immune response against B. miyamotoi, we infected C3H/HeN mice with B. miyamotoi strain LB-2001 expressing variable small protein 1 (Vsp1) and demonstrated that spirochetemia was cleared after 3 d, coinciding with anti-Vsp1 IgM production. Clearance was also observed after passive transfer of immune sera to infected SCID mice. Next, we showed that anti-Vsp1 IgG eliminates Vsp1-expressing B. miyamotoi, selecting for spirochetes expressing a variable large protein (VlpC2) resistant to anti-Vsp1. The viability of Asian isolate B. miyamotoi HT31, expressing Vlp15/16 and Vlp18, was also unaffected by anti-Vsp1. Finally, in nine HTBRF patients, we demonstrated IgM reactivity to Vsp1 in two and against Vlp15/16 in four ∼1 wk after these patients tested positive for B. miyamotoi by PCR. Our data show that B. miyamotoi is able to express various variable major proteins (VMPs) to evade humoral immunity and that VMPs are antigenic in humans. We propose that serologic tests based on VMPs are of additional value in diagnosing HTBRF.
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Affiliation(s)
- Alex Wagemakers
- Center for Experimental and Molecular Medicine, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, the Netherlands; Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520
| | - Joris Koetsveld
- Center for Experimental and Molecular Medicine, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, the Netherlands
| | - Sukanya Narasimhan
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520
| | - Melvin Wickel
- Center for Experimental and Molecular Medicine, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, the Netherlands
| | - Kathleen Deponte
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520
| | - Boris Bleijlevens
- Department of Medical Biochemistry, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, the Netherlands
| | - Seta Jahfari
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, 3720 BA Bilthoven, the Netherlands
| | - Hein Sprong
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, 3720 BA Bilthoven, the Netherlands
| | - Lyudmila S Karan
- Central Research Institute of Epidemiology, Moscow 111123, Russia
| | | | - Tom van der Poll
- Center for Experimental and Molecular Medicine, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, the Netherlands
| | - Linda K Bockenstedt
- Section of Rheumatology, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06510
| | - Adriaan D Bins
- Center for Experimental and Molecular Medicine, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, the Netherlands
| | | | - Erol Fikrig
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520
| | - Joppe W Hovius
- Center for Experimental and Molecular Medicine, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, the Netherlands;
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15
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Thorp AM, Tonnetti L. Distribution and survival of B
orrelia miyamotoi
in human blood components. Transfusion 2015; 56:705-11. [DOI: 10.1111/trf.13398] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Revised: 09/15/2015] [Accepted: 09/26/2015] [Indexed: 12/28/2022]
Affiliation(s)
- Aaron M. Thorp
- Scientific Affairs, American Red Cross Holland Laboratory; Rockville Maryland
| | - Laura Tonnetti
- Scientific Affairs, American Red Cross Holland Laboratory; Rockville Maryland
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16
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Telford SR, Goethert HK, Molloy PJ, Berardi VP, Chowdri HR, Gugliotta JL, Lepore TJ. Borrelia miyamotoi Disease: Neither Lyme Disease Nor Relapsing Fever. Clin Lab Med 2015; 35:867-82. [PMID: 26593262 DOI: 10.1016/j.cll.2015.08.002] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Borrelia miyamotoi disease (BMD) is a newly recognized borreliosis globally transmitted by ticks of the Ixodes persulcatus species complex. Once considered to be a tick symbiont with no public health implications, B miyamotoi is increasingly recognized as the agent of a nonspecific febrile illness often misdiagnosed as acute Lyme disease without rash, or as ehrlichiosis. The frequency of its diagnosis in the northeastern United States is similar to that of human granulocytic ehrlichiosis. A diagnosis of BMD is confirmed by polymerase chain reaction analysis of acute blood samples, or by seroconversion using a recombinant glycerophosphodiester phosphodiesterase enzyme immunoassay. BMD is successfully treated with oral doxycycline or amoxicillin.
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Affiliation(s)
- Sam R Telford
- Department of Infectious Disease and Global Health, Tufts University, Cummings School of Veterinary Medicine, 200 Westboro Road, North Grafton, MA 01536, USA.
| | - Heidi K Goethert
- Department of Infectious Disease and Global Health, Tufts University, Cummings School of Veterinary Medicine, 200 Westboro Road, North Grafton, MA 01536, USA
| | - Philip J Molloy
- Imugen, Inc., 315 Norwood Park South, Norwood, MA 02062, USA
| | | | - Hanumara Ram Chowdri
- Hawthorn Medical Associates, 275 Allen Street, Unit 3, New Bedford, MA 02740, USA
| | - Joseph L Gugliotta
- Hunterdon Medical Center Infectious Diseases, 1100 Wescott Drive, Suite 306, Flemington, NJ 08822, USA
| | - Timothy J Lepore
- Nantucket Cottage Hospital, 57 Prospect Street, Nantucket, MA 02554, USA
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17
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Borrelia miyamotoi infection in nature and in humans. Clin Microbiol Infect 2015; 21:631-9. [PMID: 25700888 DOI: 10.1016/j.cmi.2015.02.006] [Citation(s) in RCA: 171] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 01/31/2015] [Accepted: 02/10/2015] [Indexed: 12/23/2022]
Abstract
Borrelia miyamotoi is a relapsing fever Borrelia group spirochete that is transmitted by the same hard-bodied (ixodid) tick species that transmit the agents of Lyme disease. It was discovered in 1994 in Ixodes persulcatus ticks in Japan. B. miyamotoi species phylogenetically cluster with the relapsing fever group spirochetes, which usually are transmitted by soft-bodied (argasid) ticks or lice. B. miyamotoi infects at least six Ixodes tick species in North America and Eurasia that transmit Lyme disease group spirochetes and may use small rodents and birds as reservoirs. Human cases of B. miyamotoi infection were first reported in 2011 in Russia and subsequently in the United States, Europe and Japan. These reports document the public health importance of B. miyamotoi, as human B. miyamotoi infection appears to be comparable in frequency to babesiosis or human granulocytic anaplasmosis in some areas and may cause severe disease, including meningoencephalitis. The most common clinical manifestations of B. miyamotoi infection are fever, fatigue, headache, chills, myalgia, arthralgia, and nausea. Symptoms of B. miyamotoi infection generally resolve within a week of the start of antibiotic therapy. B. miyamotoi infection should be considered in patients with acute febrile illness who have been exposed to Ixodes ticks in a region where Lyme disease occurs. Because clinical manifestations are nonspecific, etiologic diagnosis requires confirmation by blood smear examination, PCR, antibody assay, in vitro cultivation, and/or isolation by animal inoculation. Antibiotics that have been used effectively include doxycycline for uncomplicated B. miyamotoi infection in adults and ceftriaxone or penicillin G for meningoencephalitis.
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