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

Co-infections in Persons With Early Lyme Disease

. 2019 Apr; 25(4): 748–752.
PMCID: PMC6433014
PMID: 30882316

Co-infections in Persons with Early Lyme Disease, New York, USA


In certain regions of New York state, USA, Ixodes scapularis ticks can potentially transmit 4 pathogens in addition to Borrelia burgdorferi: Anaplasma phagocytophilum, Babesia microti, Borrelia miyamotoi, and the deer tick virus subtype of Powassan virus. In a prospective study, we systematically evaluated 52 adult patients with erythema migrans, the most common clinical manifestation of B. burgdorferi infection (Lyme disease), who had not received treatment for Lyme disease. We used serologic testing to evaluate these patients for evidence of co-infection with any of the 4 other tickborne pathogens. Evidence of co-infection was found for B. microti only; 4–6 patients were co-infected with Babesia microti. Nearly 90% of the patients evaluated had no evidence of co-infection. Our finding of B. microti co-infection documents the increasing clinical relevance of this emerging infection.



Sigh…..where to even begin


  • They used serologic testing. Research has proven this form of testing is abysmal:  Key quote: “These serologic tests cannot distinguish active infection, past infection, or reinfection.”In plain English, these tests don’t show squat. While this study in the link was for Lyme testing, I assure you, serologic testing for coinfections is just as abysmal. All of these coinfections are stealthy and persistent. They purposely don’t hang out in the blood & they’ve developed strategies to avoid the immune system as well as treatment.
  • The fact they only found 1 coinfection isn’t a shocker. Some of the sickest patients NEVER test positive because of dysfunctional immune systems. I’m not sure when they are ever going to think of using a provoking agent to stir the pathogens up, kill them, and then get the dead pieces and parts into the blood where this abysmal testing for antibodies can be picked up, but I’m not going to hold my breath. This study seriously makes me want to bang my head against the wall. They’ve learned nothing and continue to do the same exact things.
  • The only thing they got right was the, increasing clinical relevance of this emerging infection,” but I’ve got news for them: this is just the tip of the iceberg.
  • They need to get Dr. Breitshwerdt in on these studies and allow him to test the patients for Bartonella using the tests he’s developed.  They also need to use provoking agents and then test, or use direct testing, and to drop the EM rash criteria like a bad habit.






Danish Study Shows Migrating Birds are Spreading Ticks & Their Pathogens – Including Places Without Sustainable Tick Populations

2019 Jan 24. pii: S1877-959X(18)30126-2. doi: 10.1016/j.ttbdis.2019.01.007. [Epub ahead of print]

Screening for multiple tick-borne pathogens in Ixodes ricinus ticks from birds in Denmark during spring and autumn migration seasons.


Presently, it is uncertain to what extent seasonal migrating birds contribute to the introduction of ticks and tick-associated pathogens in Denmark. To quantify this phenomenon, we captured birds during the spring and autumn migration at three field sites in Denmark and screened them for ticks. Bird-derived ticks were identified to tick species and screened for 37 tick-borne pathogens using real-time PCR. Overall, 807 birds, representing 44 bird species, were captured and examined for ticks during the spring (292 birds) and autumn migrations (515 birds). 10.7% of the birds harboured a total of 179 Ixodes ricinus ticks (38 ticks in spring and 141 in the autumn) with a mean infestation intensity of 2.1 ticks per bird. The European robin (Erithacus rubecula), the common blackbird (Turdus merula), and the common redstart (Phoenicurus phoenicurus) had the highest infestation intensities. 60.9% of the ticks were PCR-positive for at least one tick-borne pathogen. Borrelia DNA was found in 36.9% of the ticks. The Borrelia species detected were B. spielmanii (15.1%), B. valaisiana (13.4%), B. garinii (12.3%), B. burgdorferi s.s. (2.2%), B. miyamotoi (1.1%), and B. afzelii (0.6%). In addition, 10.6% and 1.7% of the samples were PCR-positive for spotted fever group rickettsiae and Candidatus Neoehrlichia mikurensis.

All of the tick-borne pathogens that we found in the present study are known to occur in Danish forest populations of I. ricinus. Our study indicates that migrating birds can transport ticks and their pathogens from neighboring countries to Denmark including sites in Denmark without a sustainable tick population. Thus, a tick-borne pathogen affecting human or animal health emerging at one location in Europe can rapidly be introduced to other countries by migrating birds. These movements are beyond national veterinary control. The current globalization, climatic and environmental changes affect the potential for introduction and establishment of ticks and tick-borne pathogens in Northern Europe. It is therefore important to quantify the risk for rapid spread and long distance exchange of tick-borne pathogens in Europe.



Great study until the end.  They have to mention “climatic” changes when this has been proven to be a red-herring:

Ticks are marvelous ecoadaptors and will survive harsh weather by seeking out leaf litter and snow.  In fact, warm winters have proven to be lethal to deer ticks.  In addition to that, please see links above for details on the shoddy science behind the climate model regarding ticks.

And, most importantly, as patients we must continue to insist on tax dollars and monies going for good, solid, transparent research on issues that will relieve human/animal suffering.  

Climate change data has not and will not help patients one iota.


Seroprevalence of Bb, Bm, & Powassan in Residents Bitten by Ixodes Ticks

Volume 25, Number 4—April 2019

Seroprevalence of Borrelia burgdorferi, B. miyamotoi, and Powassan Virus in Residents Bitten by Ixodes Ticks, Maine, USA

Robert P. Smith, Susan P. EliasComments to Author , Catherine E. Cavanaugh, Charles B. Lubelczyk, Eleanor H. Lacombe, Janna Brancato, Hester Doyle, Peter W. Rand, Gregory D. Ebel, and Peter J. Krause
Reports of Lyme disease in Maine, USA, have increased from a few cases in the late 1980s to 1,848 cases in 2017 (1), coinciding with range expansion of Ixodes scapularis ticks over the past 3 decades (2). The Maine Center for Disease Control reported the first 2 cases of hard-tick relapsing fever caused by Borrelia miyamotoi during 2016 and an additional 6 cases during 2017 (1). Hard-tick relapsing fever might be present as a nonspecific febrile illness (3,4). Han et al. (5) found a B. miyamotoi infection prevalence of 3.7% in adult I. scapularis ticks in Maine, ≈10-fold less than that for B. burgdorferi infection (50%, range 32%–65%) (6).

Powassan virus (POWV) encephalitis can be a devastating human infection and has infected 10 residents of Maine during 2000–2017. There are 2 variants of POWV with distinct enzootic cycles and tick vectors. Lineage 1 is transmitted by I. cookei ticks and lineage 2, sometimes referred to as deer tick virus, is transmitted by I. scapularis ticks (7). Both lineages are present in Maine (7), but lineage 1 has a lesser risk for transmission because human bites by I. cookei ticks are infrequent (8). One fatal Maine case was demonstrated to be caused by lineage 2 POWV (7). Although POWV infection prevalence in Maine I. scapularis ticks is low (0.7%–1.8%) (9), frequent exposure to I. scapularis bites (8) and rapidity of POWV transmission (i.e., POWV might be transmitted to vertebrates after only 15 min from onset of the tick bite) (10) raise concern.

To clarify frequency of exposure to B. burgdoferi, B. miyamotoi, and POWV pathogens, our objective was to determine the seroprevalence of each of these pathogens in residents of Maine, USA, who had been bitten by I. scapularis or I. cookei ticks. We also anticipated that a serosurvey might provide evidence of asymptomatic POWV infection or self-limited illness in a few persons, as reported elsewhere (11,12).

The Study

The Vector-Borne Disease Laboratory of the Maine Medical Center Research provided a free, statewide tick identification service during 1989–2013 to monitor exposure to I. scapularis ticks during range expansion of this invasive vector of human and animal disease. Persons submitted ticks that they had removed from themselves, family members, and pets. As of 2014, 33,332 ticks representing 14 species were identified in Maine; I. scapularis ticks were predominant.

During 2014 (2), we used our tick identification service database to identify persons who had removed >1 attached I. scapularis or I. cookei tick(s) from any person in the household in the previous 5 years (2009–2013). We invited these persons to participate in a serosurvey to assess past exposure to B. burgdorferi, B. miyamotoi and POWV. At the clinics, accompanying family members who self-reported as being tick-bitten were also invited to participate. The study was approved by Maine Medical Center Institutional Review Board (Protocol #4222). Participants provided informed consent (assent for minors) and submitted 30 mL of blood. Blood was centrifuged at 3,500 rpm for 15 min. Serum aliquots were stored at −20°C and then shipped to testing laboratories.

Serologic testing for antibodies to B. miyamotoi was conducted at the laboratory of one of the authors (P.J.K.). An ELISA and confirmatory Western blot assay were used to detect serum reactivity to B. miyamotoi GlpQ protein (13). For the ELISA, serum samples were diluted 1:320 and a signal >3 SD above the mean of 3 B. miyamotoi–negative serum controls was considered positive for B. miyamotoi antibody. Serum samples were considered B. miyamotoi seropositive if ELISA IgG and Western blot IgG tests yielded positive results.

Serologic evidence of exposure to B. burgdorferi was detected by the standard 2-step ELISA and Western blot assay in the Lyme Disease Serology Laboratory at Yale New Haven Hospital by one of the authors (H.D.). A reactive serum was defined as reaction to a dilution >1:100. All borderline or reactive serum were further characterized by Western blot immunoassay. Specimens were considered positive for B. burgdorferi exposure if the IgG immunoblot contained >5 of the 10 most common B. burgdorferi–associated bands (14).

Serologic testing for POWV was conducted by one of the authors (G.D.E.) by using a plaque-reduction neutralization test (PRNT) and a POWV–West Nile virus (WNV) chimeric virus (POWV–premembrane–envelope [prME]/WNV) assay as described (15). The specificity of the assay was determined by cross-neutralization studies, which demonstrated that antiserum raised against POWV efficiently neutralized chimeric POWV–prME/WNV but not WNV and that antiserum raised against WNV do not neutralize POWV–prME/WNV (15). Use of the chimeric POWV–prME/WNV assay virus enabled PRNT testing to be conducted on African green monkey kidney (Vero) cells according to standard procedures by using a 90% neutralization cutoff to be considered positive (15).

Of 230 enrolled persons, 190 were in our tick identification program database, and 40 were family members (Table 1). Among the 190 persons, 1 tick bite was from an I. cookei nymph, 13% of bites were from I. scapularis nymphs, and 86% of bites were from I. scapularis adult females. Engorgement of ticks ranged from slight (43%) to moderate (38%) to high (18%). Among the study population, 32 (13.9%) were seropositive for B. burgdorferi, 6 (2.6%) were seropositive for B. miyamotoi, and 2 (0.9%) were seropositive for both pathogens (Table 2). The serum of 1 person (0.4%) neutralized POWV at a titer of 1:20 and WNV at a titer of 1:10. We designated this serum as flavivirus positive. This person reported a history of neurologic illness for >1 year and a tick bite within the study year.


Among residents of southern Maine with a history of I. scapularis tick bites, the percentage who were seropositive for B. burgdorferi was 6 times greater than that for B. miyamotoi (13.7% vs. 2.1%) and 30 times greater than the percentage of deer ticks infected with POWV (0.4%). Because our study population consisted of persons bitten by I. scapularis ticks (with engorgement ranging from slight to high), we expected seroprevalence to be greater than that for the general population. The B. burgdorferi seroprevalence of 13.7% in our study population was ≈1.5 times higher than the seroprevalence of 9.4% reported by Krause et al. (13) in healthy residents of southern New England. In contrast, the B. miyamotoi seroprevalence of 2.1% was comparable to the seroprevalence of 3.9% reported by Krause at al. (13).

Of 1,854 cases of infection with Borrelia spp. reported in Maine in 2017, a total of 1,848 were attributed to Lyme disease and only 6 (0.3%) were attributed to B. miyamotoi (1). On the basis of a seroprevalence of ≈2% in this study and that B. miyamotoi might be transmitted by all tick stages, we believe that this disease is underdiagnosed in Maine (5). Our population was identified by history of tick exposure, rather than by symptoms. Our results therefore represent the relative frequency of exposure to these different agents rather than risk for illness.

Although the sensitivity and specificity of the 2-tier antibody assay for B. burgdorferi is better validated than those of the B. miyamotoi and POWV assays, the sensitivity and specificity of these assays are good (1315). Nonetheless, our findings might represent overestimates or underestimates of actual exposure to these agents because of false-positive or false-negative results. These data provide evidence that humans are exposed to B. burgdorferi, B. miyamotoi, and POWV in Maine and help define the prevalence of human infection caused by each of these tickborne pathogens.


  1. Maine Center for Disease Control. Reportable infectious diseases in Maine, 2017 summary; 2018. [cited 2018 Sep 18].
  2. Rand  PW, Lacombe  EH, Dearborn  R, Cahill  B, Elias  S, Lubelczyk  CB, et al. Passive surveillance in Maine, an area emergent for tick-borne diseases. J Med Entomol. 2007;44:111829. DOIPubMed
  3. Platonov  AE, Karan  LS, Kolyasnikova  NM, Makhneva  NA, Toporkova  MG, Maleev  VV, et al. Humans infected with relapsing fever spirochete Borrelia miyamotoi, Russia. Emerg Infect Dis. 2011;17:181623. DOIPubMed
  4. Krause  PJ, Fish  D, Narasimhan  S, Barbour  AG. Borrelia miyamotoi infection in nature and in humans. Clin Microbiol Infect. 2015;21:6319. DOIPubMed
  5. Han  S, Lubelczyk  C, Hickling  GJ, Tsao  JI. Transovarial transmission rate and filial infection prevalence of Borrelia miyamotoi from Ixodes scapularis collected from hunter-harvested white-tailed deer. Presented at: International Symposium on Tick-Borne Pathogens and Disease; Vienna, Austria; September 24–26, 2017.
  6. Smith  RP, Elias  SP, Borelli  TJ, Missaghi  B, York  BJ, Kessler  RA, et al. Human babesiosis, 1995–2011, Maine, USA. Emerg Infect Dis. 2014;20:172730. DOIPubMed
  7. Cavanaugh  CE, Muscat  PL, Telford  SR III, Goethert  H, Pendlebury  W, Elias  SP, et al. Fatal deer tick virus infection in Maine. Clin Infect Dis. 2017;65:10436. DOIPubMed
  8. Smith  RP Jr, Lacombe  EH, Rand  PW, Dearborn  R. Diversity of tick species biting humans in an emerging area for Lyme disease. Am J Public Health. 1992;82:669. DOIPubMed
  9. Robich  RM, Lubelczyk  C, Welch  M, Henderson  E, Smith  RP Jr. Detection of Powassan virus (lineage II) from Ixodes scapularis collected from four counties in Maine. Poster LB-5175. Presented at: 66th Annual Meeting of the American Society of Tropical Medicine and Hygiene; Baltimore, MD, USA; November 5–9, 2017.
  10. Ebel  GD, Kramer  LD. Short report: duration of tick attachment required for transmission of powassan virus by deer ticks. Am J Trop Med Hyg. 2004;71:26871. DOIPubMed
  11. Frost  HM, Schotthoefer  AM, Thomm  AM, Dupuis  AP II, Kehl  SC, Kramer  LD, et al. Serologic evidence of Powassan virus infection in patients with suspected Lyme disease. Emerg Infect Dis. 2017;23:13848. DOIPubMed
  12. El Khoury  MY, Camargo  JF, White  JL, Backenson  BP, Dupuis  AP II, Escuyer  KL, et al. Potential role of deer tick virus in Powassan encephalitis cases in Lyme disease-endemic areas of New York, U.S.A. Emerg Infect Dis. 2013;19:192633. DOIPubMed
  13. Krause  PJ, Narasimhan  S, Wormser  GP, Barbour  AG, Platonov  AE, Brancato  J, et al.; Tick Borne Diseases Group. Borrelia miyamotoi sensu lato seroreactivity and seroprevalence in the northeastern United States. Emerg Infect Dis. 2014;20:118390. DOIPubMed
  14. Centers for Disease Control and Prevention (CDC). Recommendations for test performance and interpretation from the second national conference on serologic diagnosis of Lyme disease.MMWR Morb Mortal Wkly Rep. 1995;44:5901.PubMed
  15. Nofchissey  RA, Deardorff  ER, Blevins  TM, Anishchenko  M, Bosco-Lauth  A, Berl  E, et al. Seroprevalence of Powassan virus in New England deer, 1979-2010. Am J Trop Med Hyg. 2013;88:115962. DOIPubMed


2018 Review of Previous Pathogen Transmission Time Studies in Deer Ticks

2018 Mar;9(3):535-542. doi: 10.1016/j.ttbdis.2018.01.002. Epub 2018 Jan 31.

Pathogen transmission in relation to duration of attachment by Ixodes scapularis ticks.


The blacklegged tick, Ixodes scapularis, is the primary vector to humans in the eastern United States of the deer tick virus lineage of Powassan virus (Powassan virus disease); the protozoan parasite Babesia microti (babesiosis); and multiple bacterial disease agents including Anaplasma phagocytophilum (anaplasmosis), Borrelia burgdorferi and Borrelia mayonii (Lyme disease), Borrelia miyamotoi (relapsing fever-like illness, named Borrelia miyamotoi disease), and Ehrlichia muris eauclairensis (a minor causative agent of ehrlichiosis).

With the notable exception of Powassan virus, which can be transmitted within minutes after attachment by an infected tick, there is no doubt that the risk of transmission of other I. scapularis-borne pathogens, including Lyme disease spirochetes, increases with the length of time (number of days) infected ticks are allowed to remain attached. This review summarizes data from experimental transmission studies to reinforce the important disease-prevention message that regular (at least daily) tick checks and prompt tick removal has strong potential to reduce the risk of transmission of I. scapularis-borne bacterial and parasitic pathogens from infected attached ticks.

The most likely scenario for human exposure to an I. scapularis-borne pathogen is the bite by a single infected tick. However, recent reviews have failed to make a clear distinction between data based on transmission studies where experimental hosts were fed upon by a single versus multiple infected ticks. A summary of data from experimental studies on transmission of Lyme disease spirochetes (Bo. burgdorferi and Bo. mayonii) by I. scapularis nymphs indicates that the probability of transmission resulting in host infection, at time points from 24 to 72 h after nymphal attachment, is higher when multiple infected ticks feed together as compared to feeding by a single infected tick.

In the specific context of risk for human infection, the most relevant experimental studies therefore are those where the probability of pathogen transmission at a given point in time after attachment was determined using a single infected tick. The minimum duration of attachment by single infected I. scapularis nymphs required for transmission to result in host infection is poorly defined for most pathogens, but experimental studies have shown that Powassan virus can be transmitted within 15 min of tick attachment and both A. phagocytophilum and Bo. miyamotoi within the first 24 h of attachment. There is no experimental evidence for transmission of Lyme disease spirochetes by single infected I. scapularis nymphs to result in host infection when ticks are attached for only 24 h (despite exposure of nearly 90 experimental rodent hosts across multiple studies) but the probability of transmission resulting in host infection appears to increase to approximately 10% by 48 h and reach 70% by 72 h for Bo. burgdorferi. Caveats to the results from experimental transmission studies, including specific circumstances (such as re-attachment of previously partially fed infected ticks) that may lead to more rapid transmission are discussed.



There are a number of problematic issues with this study:

  1. This is a review of previous studies.  There is nothing NEW here.  
  2. It’s important to note that ticks typically carry more than just borrelia and transmission times have not taken this fact into account: and  Infection with more than one pathogen is associated with more severe illness.  For the first time, Garg et al. show a 85% probability for multiple infections including not only tick-borne pathogens but also opportunistic microbes such as EBV and other viruses.  This is a BIG DEAL.  Finally, a study showing what we face as patients in the real world.  They also never take into account nematodes (worms), mycoplasma, tularemia, and/or Bartonella.  These are infections many if not most patients have to contend with.  Some have been bioweaponized.
  3. They assume that the most likely scenario is for a person to be bitten by one tick.  Assuming makes an ass out of u and me.  When you take into account the latest information on the Asian tick, you quickly realize the probability of coming into contact with hundreds if not thousands of ticks at one time:  While human infection has yet to be found in the U.S., this tick is responsible for plenty of misery in Asia:  It spreads SFTS (sever fever with thrombocytopenia syndrome), “an emerging hemorrhagic fever,” but the potential impact of this tick on tickborne illness is not yet known. In other parts of the world, it has been associated with several tickborne diseases, such as spotted fever rickettsioses, Anaplasma, Ehrlichia, and Borrelia, the causative agent of Lyme Disease.
  4. While they discuss the probability of multiple tick attachment, they never discuss the issue of partially fed ticks, where spirochetes would be in the salivary glands – leading to quicker transmission:  Ticks can spontaneously detach – and the authors of this study found that they did so 15% of the time in mice.  They also state that about a tenth of questing nymphs appear distended with partially fed sub-adult ticks being common.
  5. While the current review states, “There is no experimental evidence for transmission of Lyme disease spirochetes by single infected I. scapularis nymphs to result in host infection when ticks are attached for only 24 h (despite exposure of nearly 90 experimental rodent hosts across multiple studies), this study shows transmission can occur in under 16 hours:
  6.  Within this video, microbiologist Holly Ahern discusses the numerous problems with animal Bb transmission studies.  Transmission Time:  Only one study done on Mice. At 24 hours every tick had transmitted borrelia to the mice; however, animal studies have proven that transmission can occur in under 16 hours and it occurs frequently in under 24 hours.  No human studies have been done and  no studies have determined the minimum time it takes for transmission.  And, never forget the case of the little girl who couldn’t walk or talk after a tick bite attachment of 4-6 hours:
  7. They continue to blame Lyme/MSIDS on the black legged tick as the sole perp when experience and studies show there’s more potential transmitters at play:
Please, quit doing reviews of previous data and do something new using better laboratory techniques!  We don’t need MORE of the same thing.

Relapsing Fever Found at Popular Recreation Site in CA Ticks

2018 Dec 4. doi: 10.1093/jme/tjy213. [Epub ahead of print]

Borrelia parkeri in Ornithodoros parkeri (Ixodida: Argasidae) Collected Using Compact Dry Ice Traps in Madera County, California.


Tick-borne relapsing fever (TBRF) is a potentially serious vector-borne disease endemic to the western United States. Vector surveillance is compromised by the nidicolous life history of the three Ornithodoros species that transmit TBRF to people in this region. Large-scale stationary trapping methods were developed to survey a wide geographical range of Ornithodoros spp. which are known to vector relapsing fever Borrelia spp. in California. Ninety-six Ornithodoros parkeri were collected from four locations in the foothills of Fresno and Madera Counties. Two of these O. parkeri nymphs were PCR positive for Borrelia parkeri, and their collection at a popular recreation site increases the public health concern.


More on Relapsing Fever:

Relapsing Fever Spirochete Uniquely Adapted to Highly Oxidative Salivary Glands of Soft-bodied Tick

2018 Nov 29:e12987. doi: 10.1111/cmi.12987. [Epub ahead of print]

The relapsing fever spirochete Borrelia turicatae persists in the highly oxidative environment of its soft-bodied tick vector.


The relapsing fever spirochete Borrelia turicatae possesses a complex life cycle in its soft-bodied tick vector, Ornithodoros turicata. Spirochetes enter the tick midgut during a bloodmeal, and during the following weeks spirochetes disseminate throughout O. turicata. A population persists in the salivary glands allowing for rapid transmission to mammalian hosts during tick feeding. Little is known about the physiological environment within the salivary glands acini in which B. turicatae persists. In this study, we examined the salivary gland transcriptome of O. turicata ticks and detected the expression of fifty-seven genes involved in oxidant metabolism or antioxidant defenses. We confirmed the expression of five of the most highly expressed genes including glutathione peroxidase (gpx), thioredoxin peroxidase (tpx), manganese superoxide dismutase (sod-1), copper-zinc superoxide dismutase (sod-2), and catalase (cat) by reverse-transcriptase droplet digital PCR (RT-ddPCR). We also found distinct differences in the expression of these genes when comparing the salivary glands and midguts of unfed O. turicata ticks.

Our results indicate that the salivary glands of unfed O. turicata nymphs are a highly oxidative environment where reactive oxygen species (ROS) predominate, while midgut tissues comprise a primarily nitrosative environment where nitric oxide synthase is highly expressed. Additionally, B. turicatae was found to be hyperresistant to ROS compared to the Lyme disease spirochete B. burgdorferi, suggesting that it is uniquely adapted to the highly oxidative environment of O. turicata salivary gland acini.



Much can be learned about Borrelia turicatae by reading this case study:

We learn:

  • Ornithodoros turicata soft bodied ticks, are endemic to Texas and Florida
  • They are found in caves and ground squirrel or prairie dog burrows
  • Once infected, they remain infected for the rest of their lives, which can be up to ten years.
  • Attachment is painless
  • They are rapid night feeders (5-60min)
  • Due to their rapid feeding they are rarely found or leave lesions
  • Patient in study suffered with headache, nausea, & pain behind knees
  • Had numerous lesions which resolved after 6 days (without treatment)
  • Developed persistent fever
  • Developed thrombocytopenia (low platelets)
  • Developed elevated Erythrocyte sedimentation rate & C-reactive protein
  • Improved rapidly with doxycycline
  • Platelet count normalized within 2 weeks
  • Asymptomatic soldiers with similar exposure were treated prophylactically
  • TBRF is a neglected and probably underdiagnosed disease
  • Published cases in Texas have been supported by serology for the TBRF group, exposure location, and tick collections, but the authors state successful identification of B. turicatae in a human has not been reported
  • Military training groups in Israel have declared certain caves off limits because of heavy tick presence and have prophylactically administered doxycycline to those suspected to have been exposed
  • Asymptomatic patients given doxy don’t have a Jarisch-Herxheimer reaction but those with active illness do
Another study demonstrating the wily and adaptable nature of spirochetes.





Tick-borne Relapsing Fever as a Potential Veterinary Medical Problem

Tick-borne relapsing fever as a potential veterinary medical problem.

Elelu N. Vet Med Sci. 2018.


Tick-borne relapsing fever (TBRF) caused by the bacteria Borrelia, is poorly documented in veterinary medicine. Given the widespread presence of the soft tick vectors – Ornithodoros and the recently discovered hard tick vectors, as well as their close association with animal hosts, it is highly likely that infection occurs, but is rarely reported to be of veterinary importance. Sporadic reports of canine infection, some being fatal through to probable cause of abortion in horses have been published. Some of these pathogens exist in regions where there are limited diagnostic facilities, hence, they are likely to be missed and their impact on productivity may be unquantified. Here we review available literatures on cases of TBRF in domestic and wild animals in order to show their potential veterinary medical impact. Future efforts using field and laboratory surveys are needed to determine pathogenesis, vector competence and distribution in animals, their impact on animal health and productivity as well as to prevent further spill to the human population, where it is already a public health problem in some parts of the world.