borrelia miyamotoi and lyme disease


“This is the first study to investigate the presence of B. miyamotoi antibodies in a clinical population experiencing persistent symptoms and suspected tick-borne illness,” writes Delaney and colleagues from Columbia University Irving Medical Center. [1] According to the findings, Lyme disease patients testing positive for Borrelia miyamotoi were more likely to present with sleepiness and pain.

Borrelia miyamotoi (BM) is another tick-borne pathogen and “unlike Lyme disease, erythema migrans rash, and arthralgias are uncommon,” the authors write in the journal Frontiers in Medicine. The infection is diagnosed with polymerase chain reaction (PCR) called glycerophosphodiester phosphodiesterase (GlpQ) enzyme immunoassay.

Investigators looked at the incidence of BM in 82 patients who were seeking a second opinion regarding persistent symptoms which included fatigue, pain, neurocognitive, and psychiatric problems.

In their study, 1 out of 4 Lyme disease patients tested positive for Borrelia miyamotoi,using a GlpQ test. The BM positive group were significantly more likely to suffer from sleepiness (according to the Epworth Sleepiness Scale) and from pain, as measured by the McGill VAS Pain Scale, and Zung Anxiety Scale.

Eight patients with Lyme disease and Borrelia miyamotoi were hospitalized.  “Eight of 21 (38%) reported hospitalization (seven medical and one psychiatric) since symptom onset, three for cardiac and two for neurologic abnormalities,” according to the authors.

All of the patients, except for one, with Lyme disease (LD) and Borrelia miyamotoi were treated with antibiotics.  “All 21 received prior antibiotic treatment, of whom 20 received at least 2 weeks of doxycycline or amoxicillin.”

Five of the 21 patients with LD and BM lived outside of the with Northeast/Mid-Atlantic states. “Two lived in California, two lived in Florida, and one lived in Illinois.”

Study insights

The study found that clinicians are not testing for Borrelia miyamotoi, as only 1 out of the 82 study participants were tested for the infection.

Furthermore, clinicians were often dismissive of a tick-borne illness.  “Many patients reported that their clinicians dismissed the possibility of tick-borne illness both at the onset and during the course of their illness and attributed symptoms to psychological stress,” writes Delaney.

The authors raise a public health concern:

“In Lyme disease, delayed diagnosis and treatment is associated with prolonged symptoms. The same may prove true for B. miyamotoi disease.”

Editor’s note: A co-infection with Borrelia miyamotoi may explain why some Lyme disease patients are sicker than others. Unfortunately, there are still problems with the reliability of  testing for Borrelia miyamotoi.  There is also uncertainty over the best treatment approach for the infection.

  1. Delaney SL, Murray LA, Aasen CE, Bennett CE, Brown E, Fallon BA. Borrelia miyamotoi Serology in a Clinical Population With Persistent Symptoms and Suspected Tick-Borne Illness. Front Med (Lausanne). 2020;7:567350.
Many great points:
  • Could Bm explain some with persistent symptoms (highly likely)
  • Many of the patients here don’t live in what are considered Lyme-endemic areas, blowing further holes into the whole – “you have to live in the North or Eastern U.S. to be infected” paradigm.  Drop those maps like a bad habit!
  • These people had SEVERE symptoms.  Nearly 40% were hospitalized!
  • Clinicians need to WAKE UP AND SMELL THE COFFEE.  Lyme/ MSIDS patients quickly learn that those who are coinfected are sicker for longer.  Mainstream medicine is in the Stone-Ages on this fact.  There’s a real pandemic but it ain’t COVID.
  • This letter to the editor highlights the problem with coinfections & abysmal testing:

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