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

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

What Are Lyme Disease Co-Infections?

https://danielcameronmd.com/lyme-disease-co-infections/

WHAT ARE LYME DISEASE CO-INFECTIONS?

lyme disease co-infections

When Lyme disease was first discovered in 1975, it was the only known tick-borne illness recognized by clinicians. The disease, which is caused by an infection with the bacterium Borrelia burgdorferi, is transmitted through the bite of a black-legged (I. scapularis) tick.

Today, ticks harbor multiple infectious pathogens that can be transmitted to humans through a tick bite or tainted blood transfusion. The Centers for Disease Control and Prevention (CDC) now reports that “a single tick can transmit multiple pathogens, including bacteria, viruses, and parasites.” [1] This can result in patients developing what is referred to as Lyme disease “co-infections.”

In fact, between 2004 and 2016, the CDC identified 7 new tick-borne microbes capable of infecting humans. [1]

While most Lyme disease co-infections are acquired through the bite of an infected tick, several can be transmitted through contaminated blood transfusions. One investigation concluded, “Aside from a Babesia infection, Anaplasma is the most frequent transfusion-transmitted [tick-borne agent] with rapidly increasing clinical cases.” [2]

Ticks harbor multiple pathogens

According to a study in Suffolk County, Long Island, more than half (67%) of the ticks collected were harboring at least one pathogen. The causative agent of Lyme disease, Borrelia burgdorferi was the most prevalent (57% in adults; 27% in nymphs), followed by Babesia microti (14% in adults; 15% in nymphs).

Another study indicates that “co-infection occurs in up to 28% of black-legged ticks” in Lyme endemic areas of the United States.

Furthermore, researchers found that among infected ticks collected, 45% were co-infected and carried up to 5 different pathogens. The most prevalent co-infections included Bartonella henselae (17.6%) and Rickettsia of the spotted fever group (16.8%).

Lyme disease with co-infections

Researchers from Columbia University, Tufts Medical Center, and Yale School of Medicine examined the extent of co-infections in patients diagnosed with Lyme disease. Their findings are alarming.

  • 40% of Lyme disease patients had concurrent Babesia
  • 1 in 3 patients with Babesia had concurrent Anaplasmosis
  • Two-thirds of patients with Babesiosis experienced concurrent Lyme disease and one-third experienced concurrent Anaplasmosis

Recognizing and treating co-infections

As tick populations explode and expand into new geographic regions and cases of Lyme disease continue to soar, there is growing and warranted concern surrounding the medical communities’ ability to recognize, diagnose, and treat Lyme disease co-infections.

Sanchez-Vicente points out that nearly 1 in 4 black-legged ticks tested in their study had multiple infections. This finding “justifies the modification of the clinical approach to tick-borne diseases to cover all infection possibilities.”

Unfortunately, testing for co-infections rarely occurs. One study found that out of nearly 3 million specimens, only 17% were tested for non-Lyme tick-borne diseases.

Yet, an accurate diagnosis is critical, given that patients may require different treatment depending upon the type of co-infection. For instance, antibiotics prescribed for Lyme disease may be ineffective in treating parasitic or viral tick-borne diseases such as Babesia.

Most common co-infections

Lyme disease is the most common tick-borne illness in the United States. But it’s no longer the only threat. Lyme disease co-infections are becoming the norm, not the exception. The most frequently diagnosed tick-borne co-infections include Babesia, Anaplasmosis, Ehrlichia, Bartonella, Southern Tick-Associated Rash Illness (STARI), and Borrelia miyamotoi.

BABESIA

Babesia is a parasite that infects red blood cells. This parasitic infection is usually transmitted by a tick bite but can be acquired through a contaminated blood transfusion. There have also been reports of congenital transmission of Babesiosis, although rare.

Saetre describes two cases of infants with congenital babesiosis born to mothers with prepartum Lyme disease and subclinical Babesia microti infection. [3] Additionally, congenital transmission has been described in 7 previous cases, in which the infants presented with fever, anemia, and thrombocytopenia. [3]

Read more: Transfusion-transmitted Babesiosis popping up in more states in USA

Most cases of Babesia involve the strains: Babesia microti and Babesia duncani.

Symptoms typically include irregular fevers, chills, sweats, lethargy, headaches, nausea, body aches, fatigue, and in some cases, shortness of breath. But manifestations can vary.

A case series published in the Nurse Practitioner Journal demonstrates the difficulty in diagnosing the disease, as it can cause a wide range of clinical presentations.

Babesia and Lyme disease

Babesia is often present with Lyme disease and can increase the severity of Lyme disease. One study found patients co-infected with Lyme disease and Babesia experienced fatigue, headache, sweats, chills, anorexia, emotional lability, nausea, conjunctivitis, and splenomegaly more frequently than those with Lyme disease alone.

Listen to PODCAST: Delayed onset of Babesia in a Lyme disease patient

Babesia can also increase the duration of illness with Lyme disease. One study found that 50% of co-infected patients were symptomatic for 3 months or longer, compared to only 4% of patients who had Lyme disease alone.

Testing and treatment

Babesia can also be difficult to diagnose with current testing. The parasite was detected microscopically in as few as one-third of patients with Babesia. Specific amplifiable DNA and IgM antibody were more likely to be positive.

The reliability of tests for Babesia in actual practice remains to be determined.

Babesia is treated with a combination of anti-malaria medications and antibiotics such as Atovaquone with azithromycin.

EHRLICHIA

Ehrlichia is a tick-borne bacteria that infects white blood cells, but it has been found in spleen, lymph node, and kidney tissue samples. An infection with Ehrlichia can lead to Ehrlichiosis.

The infection is caused by Ehrlichia chaffeensis and Ehrlichia chagrins. The bacteria is transmitted by the Lone Star tick (Amblyomma americanum) and the black-legged tick (Ixodes scapularis).

Ehrlichia is typically transmitted by a tick bite. Only rarely, has the infection been associated with blood transfusion or organ transplant cases. According to the CDC, there have been two confirmed instances of infection occurring after kidney transplants from a common donor.

Symptoms and Treatment

Symptoms may include fatigue, fevers, headaches, and muscle aches. It can be treated with antibiotics doxycycline, minocycline, and Rifampin.

If left untreated, the disease can become severe and require hospitalization.

ANAPLASMOSIS

Anaplasmosis was previously known as Human Granulocytic Ehrlichiosis or HGE. The disease can be difficult to distinguish from Ehrlichiosis, Lyme disease, and other tick-borne illnesses.

This emerging infectious disease remains under-recognized in many areas of the United States. [4] It is caused by the bacteria Anaplasma phagocytophilum.

Anaplasmosis is spread by tick bites from the black-legged tick and western black-legged tick. Although it is reportedly rare, anaplasmosis has been transmitted through contaminated blood transfusions.

In fact, Mohan and Leiby contend that aside from a Babesia infection, “Anaplasma is the most frequent transfusion-transmitted [tick-borne agent] with rapidly increasing clinical cases.” [2]

In general, most infections with anaplasmosis are mild, “however, up to 36% of patients require hospitalization, with 3% of those having life-threatening complications.” [5]

Symptoms may include headaches, fevers, chills, malaise, and muscle aches. There have been a few reported cases describing pulmonary complications, as well. In fact, one study recommends that “anaplasmosis be included in the differential diagnosis for atypical respiratory presentations.” [5]

And although uncommon, there have been patients with anaplasmosis who did not exhibit any symptoms (asymptomatic). “It is, therefore, crucial for clinicians to be aware of potential asymptomatic anaplasmosis following a tick bite,” writes Yoo and colleagues. [6]

Anaplasmosis can be treated with antibiotics such as doxycycline, minocycline, and Rifampin.

BARTONELLA

Various Bartonella species have been found in black-legged ticks in northern New Jersey and in western black-legged ticks in California.

Bartonella can be contracted through a cat scratch or bite, causing “cat scratch fever.” But it can also be transmitted by a tick bite. In fact, “ticks and small rodents are known hosts of Bartonella and play a significant role in the preservation and circulation of Bartonella in nature.” [7]

Psychiatric presentations and other symptoms

Some patients exhibit a streak-mark rash that resembles stretch marks. Symptoms may include fever, headaches, fatigue, and swollen glands.

Several studies indicate an association between Bartonella and psychiatric symptoms. Investigators describe case studies of patients with new-onset psychiatric symptoms such as sudden agitation, panic attacks, and treatment-resistant depression possibly due to Bartonella.

Another case study highlights a young boy with a Bartonella infection who developed neuropsychiatric symptoms and was later diagnosed with pediatric acute-onset neuropsychiatric syndrome (PANS), a type of basal ganglia encephalitis. [8]

Bartonella can be treated with antibiotics such as doxycycline, minocycline, azithromycin, trimethoprim-sulfamethoxazole, clarithromycin, and Rifampin.

SOUTHERN TICK ASSOCIATED RASH ILLNESS (STARI)

STARI is an emerging tick-borne illness related to Lyme disease and was identified in the southeastern and south-central United States.

STARI is believed to be transmitted by the Lone Star tick; however, it is not officially confirmed as of yet.

The hallmark sign of STARI is an EM-like rash similar to that seen in Lyme disease. Symptoms may include fevers, headaches, stiff neck, joint pain, and fatigue.

The long term consequences and treatment of the illness have not been established.

It is not known whether antibiotic treatment is necessary or beneficial. Nevertheless, because STARI resembles early Lyme disease, physicians will often treat patients with oral antibiotics.

BORRELIA MIYAMOTOI

B. miyamotoi is increasingly being recognized as the agent of a nonspecific febrile illness often misdiagnosed as acute Lyme disease without rash, or as ehrlichiosis.” [9]

Borrelia miyamotoi (BMD) is a spiral-shaped bacteria that causes tick-borne relapsing fevers. However, investigators point out, Borrelia miyamotoi “should not be assumed to be biologically similar to the true relapsing fever spirochetes maintained by argasid (“soft”) ticks, nor to cause typical relapsing fever.” [9]

It appears to be a common infection in areas endemic for Lyme disease. [9]

Symptoms and prevalence

A 2011 study found the disease to generally present with more systemic signs and symptoms, particularly headache and fever, compared to Lyme disease. [10]

“Virtually all patients presented with fever … fatigue, and headache …. The next most common signs and symptoms were myalgia, chills, nausea and arthralgia, characterizing 30%–60% of the patients.” [10]

Other investigators report that “patients infected with B. miyamotoi in the United States typically do not have a rash.” But they may present with “a fever in conjunction with headache (96%), myalgia (84%), arthralgia (76%), and malaise/fatigue (82%).”

READ MORE: Tiny larval ticks can transmit Borrelia miyamotoi

The prevalence of the disease is unknown but investigators report that  “studies in New England suggest that Borrelia miyamotoi infection may be as common as anaplasmosis and babesiosis.

They also point out:

  • “Human cases are likely to be found wherever Lyme disease is endemic.”
  • “B. miyamotoi may cause serious complications, including meningoencephalitis in immunocompromised hosts.”
  • “Several studies suggest that B. miyamotoi may be transmitted through blood transfusion, consistent with the high levels of spirochetemia that occur with Borrelia species that cause relapsing fever.”

Borrelia miyamotoi is particularly concerning given that the bacterium can be transmitted to a person within the first 24 hours of tick attachment. And “the probability of transmission increases with every day an infected tick is allowed to remain attached.”

Diagnostic testing is limited. Although the CDC recommends using PCR and antibody-based tests to confirm a diagnose of B. miyamotoi, a recent study finds blood smears have poor sensitivity for confirming the disease. [9] And there is no FDA approved diagnostic test for the disease.

Treatment thus far is similar to that of Lyme disease. Studies show that doxycycline and amoxicillin have effectively treated B. miyamotoi infection in patients.

Remember, tick-borne co-infections are the norm, not the exception.

Editor’s Note: Practitioners should consider co-infections in the diagnosis when a patient’s symptoms are severe, persistent, and resistant to antibiotic therapy. Physicians have found that co-infections typically exacerbate Lyme disease symptoms.

References:
  1. CDC Vital Signs, Weekly / May 4, 2018 / 67(17);496–501. https://www.cdc.gov/mmwr/volumes/67/wr/mm6717e1.htm
  2. Mohan KVK, Leiby DA. Emerging tick-borne diseases and blood safety: summary of a public workshop. Transfusion. 2020 Jul;60(7):1624-1632. doi: 10.1111/trf.15752. Epub 2020 Mar 24. PMID: 32208532.
  3. Kirsten Saetre, Neetu Godhwani, Mazen Maria, Darshan Patel, Guiqing Wang, Karl I Li, Gary P Wormser, Sheila M Nolan, Congenital Babesiosis After Maternal Infection With Borrelia burgdorferi and Babesia microti, Journal of the Pediatric Infectious Diseases Society, Volume 7, Issue 1, March 2018, Pages e1–e5, https://doi.org/10.1093/jpids/pix074
  4. Rocco JM, Mallarino-Haeger C, McCurry D, Shah N. Severe anaplasmosis represents a treatable cause of secondary hemophagocytic lymphohistiocytosis: Two cases and review of literature. Ticks Tick Borne Dis. 2020 Sep;11(5):101468. doi: 10.1016/j.ttbdis.2020.101468. Epub 2020 May 23. PMID: 32723647.
  5. Jose E Rivera, Katelyn Young, Tae Sung Kwon, Paula A McKenzie, Michelle A Grant, Darrell A McBride, Anaplasmosis Presenting With Respiratory Symptoms and Pneumonitis, Open Forum Infectious Diseases, Volume 7, Issue 8, August 2020, ofaa265, https://doi.org/10.1093/ofid/ofaa265
  6. Yoo J, Chung JH, Kim CM, Yun NR, Kim DM. Asymptomatic-anaplasmosis confirmation using genetic and serological tests and possible coinfection with spotted fever group Rickettsia: a case report. BMC Infect Dis. 2020;20(1):458. Published 2020 Jun 30. doi:10.1186/s12879-020-05170-9
  7. Hao L, Yuan D, Guo L, et al. Molecular detection of Bartonella in ixodid ticks collected from yaks and plateau pikas (Ochotona curzoniae) in Shiqu County, China. BMC Vet Res. 2020;16(1):235. Published 2020 Jul 9. doi:10.1186/s12917-020-02452-x
  8. Breitschwerdt EB, Greenberg R, Maggi RG, Mozayeni BR, Lewis A, Bradley JM. Bartonella henselae Bloodstream Infection in a Boy With Pediatric Acute-Onset Neuropsychiatric Syndrome. J Cent Nerv Syst Dis. 2019;11:1179573519832014. Published 2019 Mar 18. doi:10.1177/1179573519832014
  9. Telford SR, Goethert HK, Molloy PJ, Berardi V. Blood Smears Have Poor Sensitivity for Confirming Borrelia miyamotoi Disease. J Clin Microbiol. 2019 Feb 27;57(3):e01468-18. doi: 10.1128/JCM.01468-18. PMID: 30626663; PMCID: PMC6425185.
  10. Telford SR, Goethert HK, Molloy PJ, Berardi V. Blood Smears Have Poor Sensitivity for Confirming Borrelia miyamotoi Disease. J Clin Microbiol. 2019 Feb 27;57(3):e01468-18. doi: 10.1128/JCM.01468-18. PMID: 30626663; PMCID: PMC6425185.

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For more:

Spatial and Temporal Patterns of Borrelia Miyamotoi in NY Deer Ticks

https://parasitesandvectors.biomedcentral.com/articles/10.1186/s13071-020-04569-2

Spatial and temporal patterns of the emerging tick-borne pathogen Borrelia miyamotoi in blacklegged ticks (Ixodes scapularis) in New York

Abstract

Borrelia miyamotoi, a bacterium that causes relapsing fever, is found in ixodid ticks throughout the northern hemisphere. The first cases of human infection with B. miyamotoi were identified in 2011. In the eastern USA, blacklegged ticks (Ixodes scapularis) become infected by feeding on an infected vertebrate host, or through transovarial transmission. We surveyed B. miyamotoi prevalence in ticks within forested habitats in Dutchess County, New York, and identified possible reservoir hosts. To assess spatial variation in infection, we collected questing nymphal ticks at > 150 sites. To assess temporal variation in infection, we collected questing nymphs for 8 years at a single study site. We collected questing larval ticks from nine plots to estimate the amount of transovarial transmission. To evaluate potential reservoir hosts, we captured 14 species of mammal and bird hosts naturally infested with larval blacklegged ticks and held these hosts in the laboratory until ticks fed to repletion and molted to nymphs. We determined infection for all ticks using quantitative polymerase chain reaction.

  • The overall infection prevalence of questing nymphal ticks across all sites was ~ 1%, but prevalence at individual sites was as high as 9.1%.
  • We detected no significant increase in infection through time.
  • Only 0.4% of questing larval ticks were infected.
  • Ticks having fed as larvae from short-tailed shrews, red squirrels, and opossums tended to have higher infection prevalence than did ticks having fed on other hosts.

Further studies of the role of hosts in transmission are warranted. The locally high prevalence of B. miyamotoi in the New York/New England landscape suggests the importance of vigilance by health practitioners and the public.

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**Comment**

A perfect example of how there can be high infection rates in humans but low infection rates in ticks.