Lyme disease and relapsing fever in Mexico: An overview of human and wildlife infections

Inclusion of Anti-Tick Vaccines into an Integrated Tick Management Program in Mexico: A Public Policy Challenge

Acaricides are the most widely used method to control the cattle tick Rhipicephalus microplus. However, its use increases production costs, contaminates food and the environment, and directly affects animal and human health. The intensive use of chemical control has resulted in the selection of genes associated with resistance to acaricides, and consumers are increasingly less tolerant of food contamination. This scenario has increased the interest of different research groups around the world for anti-tick vaccine development, in order to reduce the environmental impact, the presence of residues in food, and the harmful effects on animal and human health. There is enough evidence that vaccination with tick antigens induces protection against tick infestations, reducing tick populations and acaricide treatments. Despite the need for an anti-tick vaccine in Mexico, vaccination against ticks has been limited to one vaccine that is used in some regions. The aim of this review is to contribute to the discussion on tick control issues and provide a reference for readers interested in the importance of using anti-tick vaccines encouraging concerted action on the part of Mexican animal health authorities, livestock organizations, cattle producers, and academics. Therefore, it is suggested that an anti-tick vaccine should be included as a part of an integrated tick management program in Mexico.

Lyme Disease: A Review with Emphasis on Latin America

The spirochete Borrelia burgdorferi sensu lato (Lyme Group) is the causative agent of Lyme disease, transmitted to humans through tick bites carrying the bacteria. Common symptoms include fever, headache, fatigue, and the characteristic erythema migrans skin rash. If left untreated, the infection can affect joints, the cardiac system, and the nervous system. Diagnosis relies on symptoms, clinical signs (such as the rash), and potential exposure to infected ticks, with laboratory tests proving valuable when appropriately employed with validated methods. Most cases of Lyme disease respond effectively to a few weeks of antibiotic treatment. In Latin America, knowledge of Lyme disease is limited and often confounded, underscoring the significance of this review in aiding medical professionals in recognizing the disease. This study delves explicitly into Lyme disease in Argentina, neighboring countries, and other Latin American nations.

Borrelia turicatae from Ticks in Peridomestic Setting, Camayeca, Mexico

We conducted surveillance studies in Sinaloa, Mexico, to determine the circulation of tick-borne relapsing fever spirochetes. We collected argasid ticks from a home in the village of Camayeca and isolated spirochetes. Genomic analysis indicated that Borrelia turicatae infection is a threat to those living in resource-limited settings.

Argas persicus and Carios vespertilionis Ticks Infesting Ducks, Domestic Fowls and Bats in Pakistan: First Report on Molecular Survey and Phylogenetic Position of Borrelia anserina

Argasid ticks have the vectorial potential for transmitting disease-causing pathogens to avian hosts, resulting in economic losses that may not be fully estimated. Borrelia species are the responsible agents of borreliosis in poultry, animals and humans. Our previous studies have reported a high prevalence of Argas persicus infesting domestic fowls in Khyber Pakhtunkhwa (KP), Pakistan. However, molecular screening and genetic characterization of Borrelia spp. in A. persicus have been neglected in Pakistan. In this study, we focused on the molecular epidemiology and genetic characterization of Borrelia spp. associated with A. persicus ticks infesting domestic fowls and ducks, and Carios vespertilionis infesting bats in selected districts of KP. Overall, 1818 ticks, including females (415; 23%), males (345; 19%), nymphs (475; 26%) and larvae (583; 32%), were collected from 27 locations in nine districts (Peshawar, Mardan, Swabi, Charsadda, Chitral, Lakki Marwat, Bannu, Bajaur and Hangu) from domestic fowls, ducks and their shelters, and bats. A subset of 197 ticks was selected for DNA extraction and PCR to amplify fragments of the cytochrome c oxidase (cox) gene for ticks and flagellin B (flaB) for the detection and genetic characterization of associated Borrelia spp. Among these, only Borrelia anserina DNA was detected in 40 ticks (27.2%) of different life stages, where highest prevalence was found in female ticks (18; 45%), followed by nymphs (12; 30%), larvae (7; 17.5%) and males (3; 7.5%). Tick infestation in shelters (1081; 77%) was higher than on hosts (323; 23%). The resultant cox amplicons of A. persicus showed 100% identity with the same species reported from Pakistan, China, Iran, Kenya, Kazakhstan, Algeria and Egypt and C. vespertilionis show 100% identity with the species reported from Pakistan, China, Japan, Kenya, Vietnam, Spain, Netherlands, the United Kingdom and Hungry, and clustered with the aforementioned species in the phylogenetic tree. The obtained Borrelia sequences showed 100% identity with B. anserina and revealed a close resemblance to the relapsing fever group and clustered in a monophyletic clade with B. anserina from India, Iran and Brazil in a phylogenetic tree. These results establish the first molecular characterization of B. anserina in A. persicus infesting domestic fowls and ducks in the region, as well as their shelters. To effectively control zoonotic consequences, country-wide surveillance research should be encouraged to screen soft ticks infesting various birds for associated pathogens.

Perception of Ticks and Tick-Borne Diseases Worldwide

In this comprehensive review study, we addressed the challenge posed by ticks and tick-borne diseases (TBDs) with growing incidence affecting human and animal health worldwide. Data and perspectives were collected from different countries and regions worldwide, including America, Europe, Africa, Asia, and Oceania. The results updated the current situation with ticks and TBD and how it is perceived by society with information bias and gaps. The study reinforces the importance of multidisciplinary and international collaborations to advance in the surveillance, communication and proposed future directions to address these challenges.

New records of Ornithodoros turicata (Ixodida: Argasidae) in rural and urban sites in the Mexican states of Aguascalientes and Zacatecas indicate the potential for tick-borne relapsing fever

Soft ticks from the Ornithodoros genus are vectors of relapsing fever (RF) spirochetes around the world. In Mexico, they were originally described in the 19th century. However, few recent surveillance studies have been conducted in Mexico, and regions where RF spirochetes circulate remain vague. Here, the presence of soft ticks in populated areas was assessed in two sites from the Mexican states of Aguascalientes and Zacatecas. Argasidae ticks were collected, identified by morphology and mitochondrial 16S rDNA gene sequencing, and tested for RF borreliae. The specimens in both sites were identified as Ornithodoros turicata but no RF spirochetes were detected. These findings emphasize the need to update the distribution of these ticks in multiple regions of Mexico and to determine the circulation of RF borreliosis in humans and domestic animals.

Molecular and Serological Identification of Anaplasma marginale and Borrelia burgdorferi in Cattle and Ticks from Nuevo Leon, Northern Mexico

Ticks and tick-borne diseases affect livestock productivity and cause significant economic losses. Therefore, surveillance of these pathogens and vectors is paramount to reducing these effects in livestock. This study aimed to identify Anaplasma marginale and Borrelia burgdorferi sensu lato in ticks collected from cattle. Molecular biology techniques were utilized to identify A. marginale for both types of samples, i.e., ticks and bovine blood. Serology of cattle using indirect immunofluorescence assay (IFA) was conducted to determine antibodies to B. burgdorferi s.l. from seven locations in Nuevo Leon, Mexico, between 2015 and 2017. From 404 bovines, 2880 ticks were collected: Rhipicephalus microplus (2391 females and 395 males), Amblyomma spp. (51 females and 42 males) and Dermacentor variabilis (1 female). Rhipicephalus microplus represented the largest specimens captured, with 96.7% within the seven study sites. PCR processed only 15% (442) of tick samples to identify A. marginale. Field genera proportions were followed to select testing tick numbers. Results showed that 9.9% (44/442) of A. maginale infected the pooled tick species, whereas the highest percent corresponded to 9.4% (38/404) in R. microplus. Regarding the molecular analysis of blood samples, 214 of 337 (63.5%) were positive for A. maginale. In each of the seven locations, at least one bovine sample tested positive for A. maginale. Borrelia burgdorferi s.l. was not found either in the ticks or serum samples. Two A.marginale DNA nucleotide sequences obtained in this study were deposited in the GenBank with the following accession numbers OR050501 cattle, and OR050500 R.microplus tick. Results of this work point to current distribution of bovine anaplasmosis in northern Mexico.

Epidemiology of Lyme Disease

Lyme disease is the most common vector-borne illness in North America and Europe. The etiologic agent, Borrelia burgdorferi sensu lato, is transmitted to humans by certain species of Ixodes ticks, which are found widely in temperate regions of the Northern hemisphere. Clinical features are diverse but death is rare. The risk of human infection is determined by the distribution and abundance of vector ticks, ecologic factors influencing tick infection rates, and human behaviors that promote tick bite. Rates of infection are highest among children aged 5 to 15 years and adults aged more than 50 years. In the northeastern United States where disease is most common, exposure occurs primarily in areas immediately around the home. Knowledge of disease epidemiology is important for patient management and proper diagnosis.

Borrelial lymphocytoma

Borrelial lymphocytoma is a rare cutaneous manifestation of early localized European Lyme borreliosis. It manifests as a nodule or plaque with a diameter of up to a few centimeters. The lesion is, as a rule, solitary. It is more common in children than in adults and, in contrast to erythema migrans and acrodermatitis chronica atrophicans, has male predominance. A tick bite has been reported in approximately one half of patients; the tick bite is usually at the site or in the vicinity of the later borrelial lymphocytoma. The predilection site for the development of lesions is the breast in adults and the ear lobe in children. Borrelial lymphocytoma is frequently associated with erythema migrans, but rarely with other manifestations of Lyme borreliosis, and is predominantly caused by Borrelia afzelii. At presentation, approximately half of the patients with borrelial lymphocytoma have measurable serum borrelial antibodies and, in about one third, spirochetes can be cultivated from the skin lesion. A 14-day antibiotic therapy, as recommended for patients with erythema migrans, is highly successful. Posttreatment duration of a borrelial lymphocytoma is positively associated with the pretreatment duration of the lesion and with patient age, while treatment failure is associated with the clinical signs of disseminated Lyme borreliosis at presentation. Substantial improvements in knowledge on borrelial lymphocytoma and laboratory diagnostics in recent decades have contributed to earlier diagnosis and treatment. Consequently, borrelial lymphocytoma is usually a mild disease with a good prognosis.

Characterization of Immunological Responses to Borrelia Immunogenic Protein A (BipA), a Species-Specific Antigen for North American Tick-Borne Relapsing Fever

Tick-borne relapsing fever (TBRF) is a neglected vector-borne bacterial disease distributed worldwide. Borrelia turicatae, Borrelia parkeri, and Borrelia hermsii are three argasid-borne TBRF species previously implicated in human disease in North America. TBRF is likely underdiagnosed due to its nonspecific symptoms and poorly developed diagnostic tests. Studies suggest that the Borrelia immunogenic protein A (BipA) is specific to TBRF Borrelia but heterogenic between species. In this study, we hypothesized that antibody responses generated to BipA are specific to the North American TBRF species infecting a given animal. To test this, we characterized the expression and localization of native BipA in North American species of TBRF Borrelia. We also infected mice by needle inoculation or tick bite with B. turicatae, B. hermsii, or B. parkeri and evaluated serum sample reactivity to recombinant BipA (rBipA) that was produced from each species. Furthermore, serum samples from nonhuman primates and domestic dogs experimentally infected with B. turicatae were assessed. Lastly, we tested human Lyme disease (LD) serum samples to determine potential cross-reactivity to rBipA generated from B. turicatae, B. parkeri, and B. hermsii. Our findings indicate that rBipA has the potential to distinguish between infections of LD- and TBRF-causing spirochetes and that antibody responses were more robust toward the Borrelia species causing infection. This work further supports that rBipA can likely distinguish between B. turicatae, B. hermsii, and B. parkeri infections in mice, canines, and nonhuman primates. IMPORTANCEBorrelia species transmitted by soft or hard ticks cause tick-borne relapsing fever (TBRF). This is a debilitating disease distributed worldwide but is likely underdiagnosed or misdiagnosed as Lyme disease due to poorly developed diagnostic tests. Borrelia turicatae, Borrelia parkeri, and Borrelia hermsii are three TBRF species previously implicated in human disease in North America. Commonly used diagnostic methods do not identify the species causing infection. In this study, we evaluated the potential of recombinant Borrelia immunogenic protein A (rBipA) as a diagnostic antigen capable of distinguishing between infections of TBRF Borrelia species. We show that serum from mice, canines, and nonhuman primates infected with B. turicatae, B. parkeri, or B. hermsii react more strongly to the rBipA from the species causing infection. Furthermore, sera from Lyme disease patients failed to cross-react with our rBipA proteins, indicating the potential to use rBipA as a species-specific diagnostic antigen for TBRF.

Comparative genomics of the Western Hemisphere soft tick-borne relapsing fever borreliae highlights extensive plasmid diversity

BACKGROUND

Tick-borne relapsing fever (TBRF) is a globally prevalent, yet under-studied vector-borne disease transmitted by soft and hard bodied ticks. While soft TBRF (sTBRF) spirochetes have been described for over a century, our understanding of the molecular mechanisms facilitating vector and host adaptation is poorly understood. This is due to the complexity of their small (~ 1.5 Mb) but fragmented genomes that typically consist of a linear chromosome and both linear and circular plasmids. A majority of sTBRF spirochete genomes' plasmid sequences are either missing or are deposited as unassembled sequences. Consequently, our goal was to generate complete, plasmid-resolved genomes for a comparative analysis of sTBRF species of the Western Hemisphere.

RESULTS

Utilizing a Borrelia specific pipeline, genomes of sTBRF spirochetes from the Western Hemisphere were sequenced and assembled using a combination of short- and long-read sequencing technologies. Included in the analysis were the two recently isolated species from Central and South America, Borrelia puertoricensis n. sp. and Borrelia venezuelensis, respectively. Plasmid analyses identified diverse sequences that clustered plasmids into 30 families; however, only three families were conserved and syntenic across all species. We also compared two species, B. venezuelensis and Borrelia turicatae, which were isolated ~ 6,800 km apart and from different tick vector species but were previously reported to be genetically similar.

CONCLUSIONS

To truly understand the biological differences observed between species of TBRF spirochetes, complete chromosome and plasmid sequences are needed. This comparative genomic analysis highlights high chromosomal synteny across the species yet diverse plasmid composition. This was particularly true for B. turicatae and B. venezuelensis, which had high average nucleotide identity yet extensive plasmid diversity. These findings are foundational for future endeavors to evaluate the role of plasmids in vector and host adaptation.

Brown Dog Tick (Rhipicephalus sanguineus Sensu Lato) Infection with Endosymbiont and Human Pathogenic Rickettsia spp., in Northeastern México

Of the documented tick-borne diseases infecting humans in México, Rocky Mountain spotted fever (RMSF), caused by the Gram-negative bacterium Rickettsia rickettsii, is responsible for most fatalities. Given recent evidence of brown dog tick, Rhipicephalus sanguineus s.l., as an emerging vector of human RMSF, we aimed to evaluate dogs and their ticks for rickettsiae infections as an initial step in assessing the establishment of this pathosystem in a poorly studied region of northeastern México while evaluating the use of dogs as sentinels for transmission/human disease risk. We sampled owned dogs living in six disadvantaged neighborhoods of Reynosa, northeastern México to collect whole blood and ticks. Of 168 dogs assessed, tick infestation prevalence was 53%, composed of exclusively Rh. sanguineus s. l. (n = 2170 ticks). Using PCR and sequencing, we identified an overall rickettsiae infection prevalence of 4.1% (n = 12/292) in ticks, in which eight dogs harbored at least one infected tick. Rickettsiae infections included Rickettsia amblyommatis and Rickettsia parkeri, both of which are emerging human pathogens, as well as Candidatus Rickettsia andeanae. This is the first documentation of pathogenic Rickettsia species in Rh. sanguineus s.l. collected from dogs from northeastern México. Domestic dog infestation with Rickettsia-infected ticks indicates ongoing transmission; thus, humans are at risk for exposure, and this underscores the importance of public and veterinary health surveillance for these pathogens.

Surveillance and Molecular Identification of Borrelia Species in Ticks Collected at U.S. Army Garrison Humphreys, Republic of Korea, 2018-2019

Tick-borne pathogens are contributing factors for the increased incidence of vector-borne diseases throughout the world, including Lyme borreliosis, one of the most prevalent spirochetes belonging to the Borrelia burgdorferi sensu lato group. The present study focused on the detection of Borrelia species from hard ticks collected at U.S. Army Garrison Humphreys, Republic of Korea (ROK), using molecular and genotypic analyses. Tick-borne disease surveillance was conducted from January to December, 2018-2019. A total of 24,281 ticks (2 genera and 5 species) were collected from road-killed Korean Water deer (KWD) and by tick drag. Haemaphysalis longicornis (92.0%) was the most commonly collected species, followed by Haemaphysalis flava (4.9%), Ixodes nipponensis (3.1%), Haemaphysalis phasiana (0.07%), and Haemaphysalis japonica (<0.01%). The ospA gene sequences of Borrelia afzelii were detected in 12/529 pools of I. nipponensis. Three and one pools were positive for B. afzelii and Borrelia miyamotoi, respectively, using the 16s rRNA gene. None of the pools of Haemaphysalis ticks collected from KWD or by tick drag were positive for Borrelia species. I. nipponensis was collected throughout the year from KWD and from February to November by tick drag, suggesting that they were active throughout the year, and expanding the risk period for acquiring Lyme borreliosis and Borrelia relapsing fever in the ROK. This study assessed disease risk factors associated with the prevalence of Lyme disease in ticks collected from KWD and by tick drag using molecular analysis. These results provide an understanding and awareness into the prevalence and molecular characteristics of Borrelia species in the ROK.

Assessment of the potential establishment of Lyme endemic cycles in Mexico

Although Lyme disease is currently classified as exotic in Mexico, recent studies have suggested that it might be endemic there. We assessed the potential risk for the establishment of Borrelia burgdorferi transmission in Mexico. To identify the potential routes of B. burgdorferi spread, Complex Inference Networks were used initially to identify potential vector-host interactions between hard ticks (Ixodes) and migratory birds in the U.S., and a model for predicting the most important potential bird hosts of hard ticks was then obtained. By using network metrics, keystone-vectors were identified as those species with highest connectivity within and between network communities and had the potential to keep the pathogen circulating with many birds and to be dispersed to several regions. The climatic profile where these interactions occur in the U.S. was characterized and a geographic model for each keystone-vector was built. The accuracy of these models to predict areas where hard ticks have been reported positive for B. burgdorferi allows one to identify areas of greater risk of Lyme disease emergence. These hard tick-bird interactions and their climatic profile were mapped into the winter ranges of birds in Mexico. Thus, those regions in Mexico with the highest potential for becoming endemic areas of Lyme disease through the arrival of hard ticks and birds infected by B. burgdorferi were identified. These areas are candidates for future surveillance programs.

Gap Analysis of the Habitat Interface of Ticks and Wildlife in Mexico

Mexico is a highly diverse country where ticks and tick-borne diseases (TBD) directly impact the health of humans and domestic and wild animals. Ticks of the genera Rhipicephalus spp., Amblyomma spp., and Ixodes spp. represent the most important species in terms of host parasitism and geographical distribution in the country, although information on other genera is either limited or null. In addition, information regarding the influence of global warming on the increase in tick populations is scarce or nonexistent, despite climate conditions being the most important factors that determine tick distribution. In order to aid in the management of ticks and the risks of TBD in humans and domestic animals in Mexico, an analysis was conducted of the gaps in information on ticks with the purpose of updating the available knowledge of these ectoparasites and adapting the existing diagnostic tools for potential distribution analysis of TBD in wildlife. These tools will help to determine the epidemiological role of wildlife in the human–domestic animal interface in anthropized environments in Mexico.

Molecular Detection of Tick-Borne Pathogens in American Bison (Bison bison) at El Uno Ecological Reserve, Janos, Chihuahua, Mexico

American bison (Bison bison) is listed as near-threatened and in danger of extinction in Mexico. Recent studies have demonstrated the presence of several emerging pathogens at the Janos Biosphere Reserve (JBR), inhabited by one wild herd of American bison. Blood samples were collected from 26 American bison in the JBR. We tested for the presence of Anaplasma marginale, Babesia bigemina, B. bovis, Borrelia burgdorferi sensu lato, and Rickettsia rickettsii DNA using nested and semi-nested PCR protocols performing duplicates in two different laboratories. Results showed three animals (11.5%) positive for B. burgdorferi s. l., three more (11.5%) for Rickettsia rickettsii, and four (19.2%) for B. bovis. Two individuals were co-infected with B. burgdorferi s. l. and B. bovis. We found no animals positive for A. marginale and B. bigemina. This is the first report in America of R. rickettsii in American bison. American bison has been described as an important reservoir for pathogens of zoonotic and veterinary importance; thus, the presence of tick-borne pathogen DNA in the JBR American bison indicates the importance of continuous wildlife health surveys.

Borreliae Part 2: Borrelia Relapsing Fever Group and Unclassified Borrelia

Borreliae of the relapsing fever group (RFG) are heterogenous and can be divided mainly into three groups according to vectors, namely the soft-tick-borne relapsing fever (STBRF) Borreliae, the hard-tick-borne relapsing fever (HTBRF) Borreliae, the louse-borne relapsing fever (LBRF) Borreliae, and the avian relapsing fever ones. With respect to the geographical distribution, the STBRF Borreliae are further subdivided into Old World and New World strains. Except for the Avian relapsing fever group Borreliae, which cause avian spirochetosis, all the others share infectivity in humans. They are indeed the etiological agent of both endemic and epidemic forms of relapsing fever, causing high spirochaetemia and fever. Vectors are primarily soft ticks of Ornithodoros spp. in the STBRF group; hard ticks, notably Ixodes sp., Amblyomma sp., Dermacentor sp., and Rhipicephalus sp., in the HTBRF group; and the louse pediculus humanus humanus in the TBRF one. A recent hypothesis was supported for a common ancestor of RFG Borreliae, transmitted at the beginning by hard-body ticks. Accordingly, STBRF Borreliae switched to use soft-bodied ticks as a vector, which was followed by the use of lice by Borrelia recurrentis. There are also new candidate species of Borreliae, at present unclassified, which are also described in this review.

Borreliae Part 1: Borrelia Lyme Group and Echidna-Reptile Group

Simple Summary

Borreliae are spirochaetes, which represent a heterogeneous phylum within bacteria. Spirochaetes are indeed distinguished from other bacteria for their spiral shape, which also characterizes Borreliae. This review describes briefly the organization of the phylum Spirocheteales with a digression about its pathogenicity and historical information about bacteria isolation and characterization. Among spirochaetes, Borrelia genus is here divided into three groups, namely the Lyme group (LG), the Echidna-Reptile group (REPG) and the Relapsing Fever group (RFG). Borreliae Part 1 deals with Lyme group and Echidna-Reptile group Borreliae, while the subject of Borreliae Part 2 is Relapsing Fever group and unclassified Borreliae. Lyme group Borreliae is organized here in sections describing ecology, namely tick vectors and animal hosts, epidemiology, microbiology, and Borrelia genome organization and antigen characterization. Furthermore, the main clinical manifestations in Lyme borreliosis are also described. Although included in the Lyme group due to their particular clinical features, Borrelia causing Baggio Yoshinari syndrome and Borrelia mayonii are described in dedicated paragraphs. The Borrelia Echidna-Reptile group has been recently characterized including spirochaetes that apparently are not pathogenic to humans, but infect reptiles and amphibians. The paragraph dedicated to this group of Borreliae describes their vectors, hosts, geographical distribution and their characteristics.

Abstract

Borreliae are divided into three groups, namely the Lyme group (LG), the Echidna-Reptile group (REPG) and the Relapsing Fever group (RFG). Currently, only Borrelia of the Lyme and RF groups (not all) cause infection in humans. Borreliae of the Echidna-Reptile group represent a new monophyletic group of spirochaetes, which infect amphibians and reptiles. In addition to a general description of the phylum Spirochaetales, including a brief historical digression on spirochaetosis, in the present review Borreliae of Lyme and Echidna-Reptile groups are described, discussing the ecology with vectors and hosts as well as microbiological features and molecular characterization. Furthermore, differences between LG and RFG are discussed with respect to the clinical manifestations. In humans, LG Borreliae are organotropic and cause erythema migrans in the early phase of the disease, while RFG Borreliae give high spirochaetemia with fever, without the development of erythema migrans. With respect of LG Borreliae, recently Borrelia mayonii, with intermediate characteristics between LG and RFG, has been identified. As part of the LG, it gives erythema migrans but also high spirochaetemia with fever. Hard ticks are vectors for both LG and REPG groups, but in LG they are mostly Ixodes sp. ticks, while in REPG vectors do not belong to that genus.

Dermatological and Genital Manifestations of Lyme Disease Including Morgellons Disease

Although the erythema migrans (EM) skin rash is traditionally considered a hallmark of Lyme disease, other dermatological manifestations of the tickborne disease are less well known. We describe a 49-year-old woman with erosive genital ulcerations, secondary EM rashes and jagged skin lesions associated with Lyme disease. The skin rashes exhibited fibers characteristic of Morgellons disease. Molecular testing confirmed the presence of Borrelia DNA in both vaginal culture and serum specimens. In further studies on a secondary EM lesion containing filaments, Gömöri trichrome staining revealed the presence of collagen in the filaments, while Dieterle and anti-Borrelia immunostaining revealed intracellular and extracellular Borrelia organisms. Intracellular staining for Borrelia was also observed in lymphocytic infiltrates. Lyme disease may present with a variety of genital lesions and dermatological manifestations including Morgellons disease. Careful evaluation is required to determine the presence of Borrelia organisms associated with these dermopathies.

Borrelia in neotropical bats: Detection of two new phylogenetic lineages

The genus Borrelia encompasses 50 spirochetal species, several of which are pathogenic and have been detected in a wide range of mammals, especially rodents and cervids. Although the order Chiroptera is the second most diverse mammalian order, and borreliosis represents a human and veterinary health problem in endemic countries, few studies have previously reported infections of Borrelia in these flying mammals. For this reason, the aim of the present study was to detect the presence of, and to analyze the diversity of Borrelia species in several bat species from Mexico. A total of 69 bats belonging to 11 species were collected and molecular detection of Borrelia was performed by amplifying three genes using specific primers. Only five individuals of four bat species (Saccopteryxbilineata, Choeroniscus godmani, Sturnira parvidens and Lasiurus cinereus) tested positive for Borrelia DNA. We now show the first Borrelia record in Mexican bats from two different ecosystems, where previously several potential vector species of the genus Ixodes and Ornithodoros had been reported. The Borrelia sequences obtained from the bats revealed two new putative lineages, one from the relapsing fever group and the second one belonging to the Borrelia burgdorferi s.l. complex, both of which are related to zoonotic species. These results highlight the importance of bats as potential hosts of Borrelia, and the imperative need of active surveillance in flying mammals in order to understand their potential role in the life cycle of this bacteria genus.