Archive for the ‘Borrelia Miyamotoi (Relapsing Fever Group)’ Category

Ticks Climb the Mountains: Ixodes Tick Infestation and Infection by Tick-Borne Pathogens

. 2020 Sep;11(5):101489.

doi: 10.1016/j.ttbdis.2020.101489.Epub 2020 Jun 8.

Ticks climb the mountains: Ixodid tick infestation and infection by tick-borne pathogens in the Western Alps


In mountain areas of northwestern Italy, ticks were rarely collected in the past. In recent years, a marked increase in tick abundance has been observed in several Alpine valleys, together with more frequent reports of Lyme borreliosis. We then carried out a four-year study to assess the distribution and abundance of ticks and transmitted pathogens and determine their altitudinal limit in a natural park area in Piedmont region.

  • Ixodes ricinus (castor bean tick) and Dermacentor marginatus (ornate sheep tick) were collected from both the vegetation and hunted wild ungulates.
  • Tick abundance was significantly associated with altitude, habitat type and signs of animal presence, roe deer’s in particular.
  • Ixodes ricinus prevailed in distribution and abundance and, although their numbers decreased with increasing altitude, we recorded the presence of all active life stages of up to around 1700 m a.s.l., with conifers as the second most infested habitat after deciduous woods.
  • Molecular analyses demonstrated the infection of questing I. ricinus nymphs with B. burgdorferi sensu lato (15.5 %), Rickettsia helvetica and R. monacensis (20.7%), Anaplasma phagocytophilum (1.9 %), Borrelia miyamotoi (0.5 %) and Neoehrlichia mikurensis (0.5 %).
  • One third of the questing D. marginatus were infected with R. slovaca.
  • We observed a spatial aggregation of study sites infested by B. burgdorferi s.l. infected ticks below 1400 m. Borrelia-infected nymphs prevailed in open areas, while SFG rickettsiae prevalence was higher in coniferous and deciduous woods.
  • Interestingly, prevalence of SFG rickettsiae in ticks doubled above 1400 m, and R. helvetica was the only pathogen detected above 1800 m a.s.l.
  • Tick infestation on hunted wild ungulates indicated the persistence of tick activity during winter months and, when compared to past studies, confirmed the recent spread of I. ricinus in the area.

Our study provides new insights into the population dynamics of ticks in the Alps and confirms a further expansion of ticks to higher altitudes in Europe. We underline the importance of adopting a multidisciplinary approach in order to develop effective strategies for the surveillance of tick-borne diseases, and inform the public about the hazard posed by ticks, especially in recently invaded areas.



Not that ticks can’t climb mountains – but migrating birds probably dropped them there:

Regarding R. slovaca:

We also identified a case of R. slovaca infection in southern Rhineland-Palatinate. The patient reported a tick bite; the tick was identified as Dermacentor spp. Fever, lymphadenopathy of submandibular lymph nodes, and exanthema at the site of the tick bite developed 7 days later. Serologic examinations by using an immunofluorescent test (Focus Diagnostics, Cypress, CA, USA) showed antibody titers of 64 for immunoglobulin (Ig) M and 1,024 for IgG against rickettsiae of the spotted fever group. These results indicated an acute rickettsial infection. Because of strong cross-reactivity among all species in the spotted fever group, we cannot differentiate between antibodies against R. slovaca and other species in this group.




Borrelia Miyamotoi Infection in a Highly Endemic Area of Lyme Disease

Published online 2020 May 30. doi: 10.1186/s12941-020-00364-0
PMCID: PMC7260789
PMID: 32473652

Presence of Borrelia miyamotoi infection in a highly endemic area of Lyme disease


A series of cases in the Northeast of the US during 2013–2015 described a new Borrelia species, Borrelia miyamotoi, which is transmitted by the same tick species that transmits Lyme disease and causes a relapsing fever-like illness. The geographic expansion of B. miyamotoi in the US also extends to other Lyme endemic areas such as the Midwestern US. Co-infections with other tick borne diseases (TBD) may contribute to the severity of the disease. On Long Island, NY, 3–5% of ticks are infected by B. miyamotoi, but little is known about the frequency of B. miyamotoi infections in humans in this particular region. The aim of this study was to perform a chart review in all patients diagnosed with B. miyamotoi infection in Stony Brook Medicine (SBM) system to describe the clinical and epidemiological features of B. miyamotoi infection in Suffolk County, NY. In a 5 year time period (2013–2017), a total of 28 cases were positive for either IgG EIA (n = 19) or PCR (n = 9).

All 9 PCR-positive cases (median age: 67; range: 22–90 years) had clinical findings suggestive of acute or relapsing infection.

All these patients were thought to have a TBD, prompting the healthcare provider to order the TBD panel which includes a B. miyamotoi PCR test.

In conclusion, B. miyamotoi infection should be considered in the differential diagnosis for flu-like syndromes during the summer after a deer tick bite and to prevent labeling a case with Lyme disease.



Dr. Cameron states:  “Until now, there have been no treatment guidelines for B. miyamotoi and regimes have been empirically based on the treatment for Lyme disease. ‘The antimicrobial susceptibility of B. miyamotoi has not yet been elucidated, due to difficulties with cultivation of B. miyamotoi spirochetes in vitro,’ according to Koetsveld.  The study authors demonstrated that B. miyamotoi is susceptible to doxycycline, azithromycin, and ceftriaxone but resistant to amoxicillin in vitro. The next step would be to show whether these drugs work in patients.”

For more:
You might assume a patient infected with Borrelia miyamotoi, a relapsing fever spirochete, to present with a relapsing fever. However, your assumption would be wrong 48 out of 50 times, according to a case series published in the Annals of Internal Medicine. [1] The authors found that only 2 out of 50 patients infected with the relapsing spirochete B. miyamotoi actually presented with a relapsing fever. [1]….The individuals exhibited symptoms similar to those found in other tick-borne illnesses.
The majority presented with headaches, myalgias, arthralgias, and malaise/fatigue. ‘More than 50% were suspected of having sepsis, and 24% required hospitalization,’ states Molloy. [1]…..’Serologic testing using the rGlpQ EIA seems insensitive in diagnosing acute BMD infection given that it was positive for IgG or IgM in only 16% of the case patient samples at the time of clinical presentation,’ states Molloy. The rGlpQ was positive after the fact in 86% of the patients during convalescence. [1]….Elevated liver enzyme levels, neutropenia, and thrombocytopenia were common in 75%, 60% and 51% respectively.
‘Borrelia miyamotoi disease may be clinically similar to or be confused with human anaplasmosis,’ according to Molloy….B. miyamotoi has emerged as a leading cause of hard tick-transmitted infections but lacks a clear diagnostic criteria. According to Molloy, “Infection with B. miyamotoi is the fifth recognized Ixodes-transmitted infection in the northeastern United States and should be part of the differential diagnosis of febrile patientsfrom areas where deer tick–transmitted infections are endemic.’”

More of the Same Focus on Worthless Serology Testing For Borrelia Research

More of the same focus on Serology!

Ticks and Tick-borne Diseases

Identification of immunoreactive linear epitopes of Borrelia miyamotoi

Rafal Tokarz, Teresa Tagliafierro, Adrian Caciula, Nischay Mishra,b, Riddhi Thakkar, Lokendra V. Chauhan, Stephen Sameroff, Shannon Delaney, Gary P. Wormser, Adriana Marques, W. Ian Lipkin,


Borrelia miyamotoi is an emerging tick-borne spirochete transmitted by ixodid ticks. Current serologic assays for B. miyamotoi are impacted by genetic similarities to other Borrelia and limited understanding of optimal antigenic targets. In this study, we employed the TBD-Serochip, a peptide array platform, to identify new linear targets for serologic detection of B. miyamotoi.


Today’s letter to the corresponding author……

April 9, 2020

Columbia University Mailman School of Public Health
722 West 168th St.
NY, NY 10032
Attn: Rafal Tokarz, PhD, Assistant Professor of Epidemiology

Dear Prof Tokarz,

In reference to the detection of tick-borne disease, please take a moment if you will to review the following list of publications using direct detection methods for identifying ongoing spirochetal infection. I will summarize the purpose of this correspondence at the end of this list:

1. Seronegative Chronic Relapsing Neuroborreliosis.  (Stony Brook Lyme clinic)

“We report an unusual patient with evidence of Borrelia burgdorferi infection who experienced repeated neurologic relapses despite aggressive antibiotic therapy. Each course of therapy was associated with a Jarisch-Herxheimer-like reaction. Although the patient never had detectable free antibodies to B. burgdorferi in serum or spinal fluid, the CSF was positive on multiple occasions for complexed anti-B. burgdorferi antibodies, B. burgdorferi nucleic acids and free antigen.”

2. Cardiac Tropism of Borrelia burgdorferi: An Autopsy Study of Sudden Cardiac Death Associated with Lyme Carditis.(March 2016)

“Fatal Lyme carditis caused by the spirochete Borrelia burgdorferi rarely is identified. Here, we describe the pathologic, immunohistochemical, and molecular findings of five case patients.”

3. CDC Case Study #2: A case report of a 17-year old male with fatal Lyme carditis

Borrelia burgdorferi was identified via special stains, immunohistochemistry, and polymerase chain reaction. The findings support B. burgdorferi as the causative agent for his fulminant carditis and that the patient suffered fatal Lyme carditis.

4. Granulomatous hepatitis associated with chronic Borrelia burgdorferi infection: a case report

The patient had active, systemic Borrelia burgdorferi infection and consequent Lyme hepatitis, despite antibiotic therapy. Spirochetes were identified as Borrelia burgdorferi by molecular testing with specific DNA probes.

5. Culture evidence of Lyme disease in antibiotic treated patients living in the Southeast.

Rudenko and colleagues reported culture confirmation of chronic Lyme disease in 24 patients in North Carolina, Florida, and Georgia. All had undergone previous antibiotic treatment

6. DNA sequencing diagnosis of off-season spirochetemia with low bacterial density in Borrelia burgdorferi and Borrelia miyamotoi infections.

Faulty/misleading antibody tests landed a sixteen year old male in a psychiatric ward when his lab results did not meet the CDC’s strict criteria for positive results. His Western blot had only four of the required five IgG bands. Subsequent DNA sequencing identified a spirochetemia in this patient’s blood so his psychiatric issues were a result of neurologic Lyme disease misdiagnosed by antiquated/misleading serology. This patient was previously treated with antibiotics.

7. The Long-Term Persistence of Borrelia burgdorferiAntigens and DNA in the Tissues of a Patient with Lyme Disease

Autopsy tissue sections of the brain, heart, kidney, and liver were analyzed by histological and immunohistochemical methods (IHC), confocal microscopy, fluorescent in situ hybridization (FISH), polymerase chain reaction (PCR), and whole-genome sequencing (WGS)/metagenomics. We found significant pathological changes, including borrelial spirochetal clusters, in all of the organs using IHC combined with confocal microscopy.

8. Persistent Borrelia Infection in Patients with Ongoing Symptoms of Lyme Disease

“This pilot study recently identified chronic Lyme disease in twelve patients from Canada. All of these patients were culture positive for infection (genital secretions, skin and blood) even after multiple years on antibiotics so there was no relief from current antimicrobials. Some of these patients had taken as many as eleven different types of antibiotics.”


Note: For the sake of time this is just a short list of the hundreds of publications identifying persistent Borrelia infection.

What is the purpose of this email?

Direct detection methods, specifically DNA testing has the ability to identify persistent infection whereas serology cannot be used to gauge treatment failure or success. Not to mention that humans do not produce antibodies against Borrelia for 4-6 weeks after a tick bite. By the time serology tests are positive, the spirochetes have already invaded various deep tissues, like those in syphilis, and are hard to eradicate with antibiotics.

Serology has allowed the 30-year dogma to persevere [1]whereas direct detection methods are exposing the exact opposite.

We are dealing with a life-altering/life-threatening infection with faulty/misleading antibody tests, inadequate treatment, no medical training and absolutely no disease control whatsoever; a public health disaster.

It is time to utilize 21st century technology for the purpose of rapid detection and efficacy of treatment.

If DNA testing is accepted for the 21st century pandemic (COVID-19) [2] ; why not for the 20th century plague (Lyme disease) that has been allowed to proliferate unchecked?

Respectfully Submitted,

Carl Tuttle
Lyme Endemic Hudson, NH

Cc: The tick-Borne Disease Working Group


1. Lyme Disease Is Hard to Catch And Easy to Halt, Study Finds
New York Times By GINA KOLATA Published: June 13, 2001

2. The Science Behind the Test for the COVID-19 Virus


Email to the attention of Dr. Paul Mead, Chief of the CDC Bacterial Diseases Branch

Today’s letter to Paul Mead of the CDC regarding the continued use of serology mentioned in the latest study on Borrelia miyamotoi at the top of the page.

Apr 13, 2020

Division of Vector-Borne Diseases
Centers for Disease Control and Prevention
3156 Rampart Rd
Fort Collins, Colorado CO 80521
Attn: Paul Mead, MD, MPH Acting Branch Chief

Dear Dr. Mead,

In October of 2018 you coauthored the following paper in Clinical Infectious Diseases and made the following statement regarding serologic testing for Lyme disease:

Direct Diagnostic Tests for Lyme Disease

Clinical Infectious Diseases, ciy614,

Published: 11 October 2018

Excerpt:  (Quote from Paul Mead)

“… serologic tests cannot distinguish active infection, past infection, or reinfection. Reliable direct-detection methods for active B. burgdorferi infection have been lacking in the past but are needed and appear achievable.”

Dr. Mead…. So why is the National Institutes of Health funding Dr. Gary Wormser’s study for the serologic detection of B. miyamotoi?

Obviously Dr. Wormser didn’t get your memo or you are just providing lip service to give the illusion that our public health officials have everything under control.

What is the status of Direct Diagnostic Tests for Lyme Disease Dr. Mead? Persistent infection after extensive antibiotic treatment has been identified through the use of direct detection methods in academic centers and autopsy findings [1]yet the average patient cannot obtain these tests to justify how sick they are with their chronic active infection.

Please provide a list of grants issued by the CDC or National Institutes of Health for studies actively involved in developing Direct Diagnostic Tests for Lyme Disease.

I expect a prompt reply to this inquiry.

Respectfully submitted,

Carl Tuttle

Lyme Endemic Hudson, NH


[1] More of the same focus on Serology!


For more on the concerted suppression of direct testing for borrelia:

BTW: The CDC is directly behind the COVID-19 testing fiasco.  This article points out that insisting upon their own tests is the MO of the CDC – even when human lives are at stake: The reason for this is so they control all the parameters for further products that will make them money – everything from test kits to drugs to vaccines.

The CDC has controlled Lyme testing for decades and it rules like the iron curtain even though research clearly shows it is abysmal and misses at least half of all cases – and often times much more.

Four Borrelia Species Found in Ticks in North-Eastern Germany

2020 Feb 27;13(1):106. doi: 10.1186/s13071-020-3969-7.

Borrelia miyamotoi and Borrelia burgdorferi (sensu lato) identification and survey of tick-borne encephalitis virus in ticks from north-eastern Germany.



Ixodes ricinus is the most common tick species in Europe and the main vector for Borrelia burgdorferi (sensu lato) and tick-borne encephalitis virus (TBEV). It is involved also in the transmission of Borrelia miyamotoi, a relapsing fever spirochete that causes health disorders in humans. Little is known regarding the circulation of Borrelia species and the natural foci of TBEV in north-eastern Germany. The goal of this study was to investigate the infection rates of Borrelia spp. and of TBEV in I. ricinus ticks from north-eastern Germany.


Ticks were collected by flagging from 14 forest sites in Mecklenburg-Western Pomerania between April and October 2018. RNA and DNA extraction was performed from individual adult ticks and from pools of 2-10 nymphs. Real time reverse transcription PCR (RT-qPCR) targeted the 3′ non-coding region of TBEV, while DNA of Borrelia spp. was tested by nested PCR for the amplification of 16S-23S intergenic spacer. Multilocus sequence typing (MLST) was performed on B. miyamotoi isolates.


In total, 2407 ticks were collected (239 females, 232 males and 1936 nymphs). Female and male I. ricinus ticks had identical infection rates (both 12.1%) for Borrelia spp., while nymphal pools showed a minimum infection rate (MIR) of 3.3%. Sequencing revealed four Borrelia species: B. afzelii, B. garinii, B. valaisiana and B. miyamotoi.

  • Borrelia afzelii had the highest prevalence in adult ticks (5.5%) and nymphs (MIR of 1.8%)
  • Borrelia miyamotoi was identified in 3.0% of adults and registered the MIR of 0.8% in nymphs
  • Borrelia valaisiana was confirmed in 2.5% adult ticks and nymphs had the MIR of 0.7%
  • B. garinii was present in 1.1% of adults and showed a MIR of 0.1% in nymphs
  • The MLST of B. miyamotoi isolates showed that they belong to sequence type 635.
  • No tick sample was positive after RT-qPCR for TBEV RNA.


The prevalence of B. miyamotoi in I. ricinus ticks registered similar levels to other reports from Europe suggesting that this agent might be well established in the local tick population.

The detection of B. burgdorferi (s.l.) indicates a constant circulation in tick populations from this region.



If four borrelia species were discovered in German ticks, it’s highly likely these same ticks are transmitting to humans. German patients are sunk if doctors are utilizing worthless CDC 2-tiered testing as it ONLY uses one strain, which isn’t even discussed in this paper (B. burgdorferi).

Borrelia afzelii, miyamotoi, and garinii ALL are pathogenic to humans.

This 2004 article shows they found valaisiana in the cerebrospinal fluid in a, 61-year-old man with a history of spastic paraparesis, which is strong clinical evidence of advanced neuroborreliosis.” They further state, “This report is the first of genetic detection of B. valaisiana in CSF, which indicates a probable association of this genospecies with disease in humans.”

Sixteen years later we still don’t know if valaisianna is pathogen to humans.

This, right here, is why we don’t need more climate data.
We need to know what is causing disease in humans, and how to detect it (test), and treat it.

For more:

Tick-borne Relapsing Fever: An Unrecognized Cause of Fever in Travelers

2020 Jan 31. pii: S0248-8663(20)30010-2. doi: 10.1016/j.revmed.2019.12.022. [Epub ahead of print]

Tick-borne relapsing fever : An unrecognized cause of fever in travelers

[Article in French]



Tick-borne relapsing fever is a usual cause of fever in West Africa. Except relapsing febrile episodes, there are no pathognomonic signs and diagnosis is difficult because Borrelia density in patient’s blood is low.


Tick-borne relapsing fever was revealed by the presence of spirochetes in a blood sample to search malaria in two men, 24 and 31 year-old, returned from Mali.


This diagnosis should be evocated in patients having fever after a trip in infested area, as malaria, both infections can be associated.



I got news for you.  Borrelia density is low in many patients’ blood.  This is a common problem and one of the reasons why patients continue to test negative.