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

Lyme Disease-Causing Bacteria Spotted on Routine Blood Films

https://news.mayocliniclabs.com/2021/08/11/rare-lyme-disease-causing-bacteria-spotted-on-routine-blood-films/

Rare Lyme Disease-Causing Bacteria Spotted on Routine Blood Films

Eye on Innovation features exciting advances taking place at Mayo Clinic Laboratories. This monthly series shines a spotlight on recently developed tests and highlights how Mayo Clinic translates ideas and discoveries into testing resources that improve diagnosis and care for patients across the globe.

The bacterium was revealed through Mayo Clinic Laboratories’ polymerase chain reaction (PCR) blood test for Lyme disease (Test ID: PBORR). That PCR testing is the preferred method for differentiating between the two bacteria. People who have B. mayonii infection also may test positive with the Lyme disease serology test (Test ID: LYME), but the test will not distinguish a B. mayonii infection from a B. burgdorferi infection.

It’s long been known that Lyme disease is caused by bacteria transmitted through the bite of an infected black-legged tick (otherwise known as the deer tick). The understanding for many years was that one species of bacteria was the main culprit behind Lyme disease in the United States: Borrelia burgdorferi.

But in 2016, researchers at Mayo Clinic discovered a new species of bacteria that causes Lyme disease. They named it Borrelia mayonii, after Mayo Clinic’s founders, Drs. William and Charles Mayo.

A key difference that has been noted between B. mayonii and B. burgdorferi is that B. mayonii spirochetes are found at high levels in peripheral blood, whereas B. burgdorferi spirochetes are not. Researchers surmised that meant the B. mayonii spirochetes potentially could be found on routine peripheral blood smears.

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Borrelia mayonii, Aug. 18, 2021

“IT IS IMPORTANT FOR PATHOLOGISTS AND LABORATORIANS TO KNOW THAT SPIROCHETES OF BORRELIA MAYONII CAN OCCASIONALLY BE SEEN ON ROUTINE PERIPHERAL BLOOD SMEARS,” SAYS BOBBI PRITT, M.D., CHAIR OF MAYO’S DIVISION OF CLINICAL MICROBIOLOGY AND THE PAPER’S LEAD AUTHOR. “OTHERWISE, THEY WOULD PROBABLY ASSUME THAT THE SPIROCHETES WERE FROM THE BORRELIA SPECIES THAT CAUSE RELAPSING FEVER, WHICH IS VERY DIFFERENT FROM LYME DISEASE.”

Because B. mayonii has only been found in the Upper Midwest of the United States, it remains a rare cause of Lyme disease and may frequently go undetected. Understanding that its spirochetes can occasionally be visualized in routine blood films may raise awareness and recognition of the uncommon bacterium, and it could point the way to more consistent and accurate diagnosis of this cause of Lyme disease.

That proved to be true earlier this year when staff in Mayo Clinic’s Division of Clinical Microbiology observed several spirochaetes on thin blood films from a specimen that had tested PCR positive for B. mayonii. The bacteria were confirmed to be B. mayonii through genome sequencing. The findings were published in July in the journal Clinical Microbiology and Infection.

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**Comment**

Since Borrelia miyamotoi is not a reportable illness to the CDC, no one has any clue about prevalence, and despite authorities continually stating it’s “rare,” reports are coming in continually that it’s highly likely to be a much bigger problem than ‘authorities’ believe.  Also, despite their statement that Bm has only been found in the upper midwest in the U.S., California ticks have carried Bm for a long time, and there are reports of it worldwide.

It was recently discovered that:

For more:

What is Borrelia miyamotoi?

https://danielcameronmd.com/what-is-borrelia-miyamotoi/

WHAT IS BORRELIA MIYAMOTOI?

What is Borrelia miyamotoi

What is Borrelia miyamotoi? This tick-borne illness, transmitted by deer ticks, is believed to be underrecognized and a growing concern, as studies indicate a B. miyamotoi infection may be as common as anaplasmosis and babesiosis. Researchers randomly tested 250 individuals living in Manitoba, Canada and found that 10% were seropositive for B. miyamotoi. [1]

Borrelia miyamotoi (B. miyamotoi) was first reported in the United States in 2013 but has become increasingly more common.  The tick-borne illness can be transmitted by the same tick that carries Borrelia burgdorferi, the Lyme disease pathogen. In their article, Della-Giustina and colleagues² address the question, “What is Borrelia miyamotoi?” and concerns surrounding this growing threat.

Where is B. miyamotoi found?

Borrelia miyamotoi (B. miyamotoi) can be found in various ticks including the deer tick. It has been detected in ticks located in the northeastern and northern Midwestern United States, California, Europe, and Asia.

What stage of deer ticks transmit B. miyamotoi?

Borrelia miyamotoi can be transmitted from all stages of a tick including the larval stage. The larval tick can harbor and transmit B. miyamotoi by passing the pathogen from the parent to the offspring, a process called transovarial transmission.

How fast can B. miyamotoi be transmitted?

Quickly, according to the authors.  “B. miyamotoi can be transmitted 10% of the time within the first 24 hours of attachment, increasing steadily to reach 73% for a complete feeding.  Thus, transmission of B. miyamotoi is more rapid than transmission of B. burgdorferi.”²

Symptoms of B. miyamotoi

The symptoms that have been described include fever, malaise, headache, and myalgias.  Some cases present with an elevated liver test, low white count and abnormal liver tests that have been described in Anaplasmosis, another tick-borne illness.  Only 11% of patients presented with an erythema migrans rash, according to findings from a case series.

Making the diagnosis

It can be difficult to diagnose B. miyamotoi“No test specific to B. miyamotoi has been approved by the United States Food and Drug Administration as of October 2020,” the authors explain.

“The most specific test currently available in several public health and commercial laboratories is polymerase chain reaction (PCR) testing of blood or cerebrospinal fluid for the B. miyamotoi GlpQ enzyme.”

“Serologic testing of B. miyamotoi IgM and IgG antibodies is possible by a few commercial laboratories.” Unfortunately, it can be hard to interpret these tests, as they may cross-react to other spirochetes.  (The authors did not address the risk of cross reactions.)

“One test using this approach, the TBD serochip, is an array-based assay testing for 8 different tick-borne diseases, including B. miyamotoi. Developed in 2018, it is promising but has not yet become widely available.”

Treatment of B. miyamotoi 

There are no evidence-based trials to determine the best treatment for B. miyamotoi. Doxycycline has been suggested, as Lyme disease patients have improved with doxycycline.  “In vitro analysis has shown the susceptibility of B. miyamotoi to ceftriaxone, azithromycin, and doxycycline, with resistance to amoxicillin,” the authors explain.

Prophylactic treatment

Since B. miyamotoi can be transmitted rapidly, it may be prudent to consider prophylactic antibiotic treatment immediately, even if the tick has not been attached for 24 to 36 hours.

“Understanding this more rapid transmission of infection of B. miyamotoi may be a consideration in determining prophylactic treatment for tick bites with a shorter time of attachment in endemic areas for B. miyamotoi.”

References:
  1. 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(3):E690-E693.
  2. Della-Giustina D, Duke C, Goldflam K. Underrecognized Tickborne Illnesses: Borrelia Miyamotoi and Powassan Virus. Wilderness Environ Med. Jun 2021;32(2):240-246. doi:10.1016/j.wem.2021.01.005

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**Comment**

I’m always extremely skeptical of ALL information given on transmission times as reality has shown a far different picture.  For more on this:  https://madisonarealymesupportgroup.com/2017/04/14/transmission-time-for-lymemsids-infection/   Important to note: minimum transmission time has never been determined and reality shows it can happen within a few hours.  Certain coinfections can happen within minutes.

Since Borrelia miyamotoi is not a reportable illness to the CDC, no one has any clue about prevalence but reports are coming in continually that it’s highly likely to be a much bigger problem than ‘authorities’ believe.

It was recently discovered that:

Tickborne Illnesses in Finland

https://www.lymedisease.org/ticks-finland-2/

TOUCHED BY LYME: Tick-borne illnesses in Finland

April 28, 2021

Guest blogger C.M. Rubin interviews two European scientists about the prevalence of Lyme disease and other tick-borne infections in Finland.

The Global Search for Education: Finland — Ticks

by C M Rubin as featured in the Huffington Post

Lyme disease is caused by a bacterium transmitted to humans via a tick bite. The CDC (Center for Disease Control) claims that Lyme Borreliosis is the most common and fastest growing infectious illness in the United States. The disease can cause a variety of flu-like symptoms such as fever, achy joints, fatigue and headache. Additionally, Anaplasmosis/Ehrlichiosis, Babesiosis, Rocky Mountain Spotted Fever, Bartonella, Tularemia, and more recently, Borrelia Miyamotoi (a distant relative of Lyme Borreliosis) are other recognized tick-borne infectious diseases in the United States.

Experts have been unable to agree for decades on whether a case definition called chronic Lyme disease exists. Yet, some Lyme victims, even after taking the standard treatment of antibiotics, continue to suffer from long-term and often serious health problems for years after they first contract the disease. Does chronic Lyme disease exist, or is the condition which some patients experience an autoimmune or nervous system response triggered by the infection, or indeed is it a bit of both? These are some of the major questions researchers are trying to figure out as they take on the enormous challenges of identifying better Lyme diagnostic tools and treatment plans for what is becoming a growing global public health crisis.

Today in The Global Search for Education, I take a look at tick-borne illnesses in Finland. I am joined by Docent Jarmo Oksi, Finland’s leading researcher in the field of Lyme disease, who is based at the University of Turku in Finland. In addition, I welcome Markku Kuusi, Chief Medical Officer from Finland’s National Institute for Health and Welfare.

2013-04-25-cmrubinworldticks1400.jpg“The weakness of the Finnish surveillance system is that we don’t collect any clinical information on patients, we only get notifications from laboratories.” — Markku Kuusi
What is the annual incidence of Lyme disease in Finland and in Europe at large?Jarmo: Laboratory reports on Lyme Borreliosis cases (based on positive serology) have doubled in 10 years and are now about 1,500. The estimated number of Lyme Borreliosis infection cases is about four times this number — i.e. estimated incidence in Finland is 5,000-6,000 annually (population 5.5 million), which is about 100 per 100,000 inhabitants per year. However there are areas in the Southwestern Archipelago with incidence of 1000 per 100,000 inhabitants per year.

Markku: Based on the National Infectious Disease Register, the incidence of Lyme disease in Finland has been about 30/100,000 during the past few years. In terms of the annual incidence in other Nordic countries, in Norway it has been about 6/100,000 and in Denmark, 1 – 2/100,000. It is hard to believe that there is such a difference in actual incidence, so that is why I believe the diagnostic criteria are truly different. The weakness of the Finnish surveillance system is that we don’t collect any clinical information on patients, we only get notifications from laboratories; so it is difficult to say whether the symptoms of our cases really are compatible with Lyme Borreliosis.

Would you comment on the annual incidence of any of the other tick-borne illnesses which are endemic in Finland in addition to Lyme.

Markku: Tick-borne Encephalitis (TBE) is another important tick-borne disease in Finland. The incidence has been particularly high on Aland Island and therefore TBE vaccination is included in the national immunization program. Before the vaccination program, the annual incidence was up to 100/100,000 population. Now it has decreased substantially. It seems that in other parts of Finland (apart from Aland Island), the incidence is increasing, and therefore other areas may also be included in the immunization program in the near future (for example, the Archipelago around the city of Turku).

Do you believe that chronic Lyme disease exists or that it is a misnomer for other diseases triggered by Lyme disease?

Markku: This is a difficult question. I think it is clear that some patients have a prolonged course of the disease which may last several months. The most experienced clinicians in Finland think that a continuing Borrelia infection is possible if the patient has not received adequate treatment for the illness, resulting in disseminated infection. Even after adequate treatment, some patients have symptoms due to immunological mechanisms, but it is very hard to say whether these symptoms are related to Borrelia infection or to some other causes.

2013-04-25-cmrubinworldlabra_182.JPG_3420500.jpg“The most experienced clinicians in Finland think that a continuing Borrelia infection is possible if the patient has not received adequate treatment for the illness, resulting in disseminated infection.”— Markku Kuusi
If you believe in chronic Lyme disease, what do you believe are the most effective ways to treat it?Jarmo: If you mean chronic infection, I think that this entity after standard antibiotic therapy is very very seldom (I see about one case in five years). However, if detected –e.g. with cultivation or PCR (the most specific way to detect), the treatment I give is individual antibiotic treatment — maybe double the length compared to the initial treatment.

What do you believe is the most effective way to treat symptoms triggered by the infection, e.g. chronic auto-immune reaction?

Jarmo: During the first months I wait for gradual improvement. If there is no improvement after six to 12 months, I then start low-dose corticosteroid treatment for a certain subset of patients. Some other subsets may get help from, for example, amitriptyline, which raises the threshold for pain sensation.

What tests currently available to the general public, other than the Western Blot test, do you believe provide a better degree of certainty?

Jarmo: PCR (and culture) are useful in some situations (culture only in research settings), but even PCR is not sensitive enough to detect all cases — e.g. in CSF (cerebrospinal fluid) of neuroborreliosis cases. Besides Western Blots, ELISA tests based on C6 peptide are generally good as confirmatory tests.

2013-04-25-cmrubinworld_P6Q5372.JPG_198500.jpg“We are currently enrolling patients into a study on neuroborreliosis: comparison of IV Ceftriaxone for 3 weeks vs. oral Doximycin for 4 weeks. Hopefully this study will give us new knowledge on markers of how to identify patients with reactive symptomatology triggered by Lyme neuroborreliosis.”— Jarmo Oksi
Are you aware of any other promising tests in development?Markku: Last year, a Finnish group reviewed the diagnostic tests in our country. It is my understanding that right now there are not unfortunately any new reliable tests available. So we shall have to wait awhile for them.

To what research do you believe scientists around the world must give priority in order to overcome the challenges the public faces with finding a cure for Lyme disease?

Markku: I think it is important to better understand the mechanism behind the sequelae of acute borreliosis. Therefore, we need more research on the immunology of the disease. In other words, how does the bacteria actually cause joint symptoms or neurologic symptoms. I think this will help us to develop better diagnostic tests and hopefully better drugs. I believe antibiotics are not the only solution.

What is the focus of your research and how does it relate to the challenges of identification and cure of Lyme disease and diseases triggered by Lyme?

Jarmo: We are currently enrolling patients into a study on neuroborreliosis: comparison of IV Ceftriaxone for three weeks vs. oral Doximycin for four weeks. Hopefully this study (with control CSF specimens) and long follow-ups of patients also will give us new knowledge on markers of how to identify patients with reactive symptomatology triggered by Lyme neuroborreliosis.

How can technology help us find a cure for Lyme disease faster?

Markku: This is not really a field in which I am knowledgeable, but I believe that better molecular and immunological methods may give possibilities for new diagnostics and for the development of new drugs. What I really hope is that there will be better and more specific laboratory tests for Lyme Borreliosis in the future. I think that one of the key issues is to harmonize the laboratory methods so that we can get a better understanding of the epidemiology of Lyme disease in Finland.

C M Rubin is a child and family health and education advocate.  She is the author of a number of award winning books as well as the widely read online series THE GLOBAL SEARCH FOR EDUCATION.

Follow C. M. Rubin on Twitter: www.twitter.com/@cmrubinworld

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**Comment**

I disagree with two tenets in this paper:

  • Chronic Lyme is rare.  I personally, as well as my husband, and most I deal with have improved immensely or even reached remission with lengthy treatment utilizing numerous antimicrobials and other modalities.  As they say, “The proof is in the pudding.”  Lyme spirochetes have been found in the autopsied brain despite treatment.  There are also extensive global research showing the persistence of the organism in 700 peer-reviewed papers (as well as coinfections that often come with Lyme): Peer-Reviewed Evidence of Persistence of Lyme:MSIDS copy  Please keep in mind that everything is rigged against reporting chronic infection. Globally, doctors work under the CDC/IDSA’s myopic focus on the acute phase and frank denial of persistent infection.  It doesn’t surprise me at all that a Finnish researcher also cow-tows to this thinking.  It’s rampant.
  • That we need yet more research on the acute phase of Lyme.  Frankly, that’s about all we have.  We desperately need researchers to quit myopically focusing on this phase of the illness and study the thousands upon thousands with chronic/persistent symptoms who often do to not test positive on the abysmal CDC 2-tiered testing, which is rigged to not pick up chronic infection, and do not have the “classic” EM rash.  These two variables have kept the sickest patients from being studied.

Know Your Ticks

https://www.globallymealliance.org/tick-table/

Know your ticks

Easy to read table shows the most common ticks found in the U.S. that transmit pathogens to humans.
Note: only a partial list. To learn more about tick-bite prevention and how to be Tick AWARE, click here

Click here to download the Tick Table

Tick Table

For more:

Remember, in Wisconsin, ticks are found in every county in the state. Researchers are also finding them in bright, open, mowed lawns.

Wildlife Borrelia Infection in Atlantic Canada

Wildlife Borrelia infection in Atlantic Canada:

Assessing the prevalence of Borrelia in wildlife hosts

Christopher Zinck

Mount Allison University

Lyme Research Network

Wildlife-Borrelia-infection-in-Atlantic-Canada-Assessing-the-prevalence-of-Borrelia-in-wildlife-hosts-Christopher-Zinck(1)  Slides Here

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Important findings:

  • Reservoir species are abundant
  • There are more Borrelia out there than B. burgdorferi (testing will miss all of them)
  • Different Borrelia species show different tissue tropisms (cells and tissues of a host which support growth of bacteria) in the body – B. miyamotoi is much more widely dispersed in the body in wild mice than Bb