Borrelia miyamotoi Disease in the Northeastern United States

Abstract

IMUGEN.

Transmission of the relapsing fever spirochete, Borrelia miyamotoi, by single transovarially-infected larval Ixodes scapularis ticks

“…It now appears that hard tick-borne relapsing fever may be an exception in this respect: our experimental demonstration of transmission of B. miyamotoi by larval ticks supports the idea put forth in epidemiological studies (Molloy et al, 2015; Fiorito et al, 2017) that transovarially-infected larvae are involved as vectors of this relapsing fever spirochete to humans in the United States. Pathogen transmission by I. scapularis larvae is especially concerning in the Northeast, where the seasonal timing of peak larval activity (summer) is distinct from that of both peak nymphal activity (late spring) and peak activity of female ticks (fall and early spring).…”

“…The relapsing fever spirochete, Borrelia miyamotoi, is increasingly recognized as a cause of human illness (hard tick-borne relapsing fever) in the United States (Krause et al, 2013, 2014; Molloy et al, 2015; Fiorito et al, 2017). The primary vector of B. miyamotoi to humans in the eastern part of the United States is the blacklegged tick, Ixodes scapularis , which also transmits the Lyme disease spirochetes, Borrelia burgdorferi sensu stricto (s.s.) and Borrelia mayonii (Krause et al, 2015; Breuner et al, 2017; Eisen, 2018).…”

“…Two recent epidemiological studies from the Northeastern United States indicate that human cases of hard tick-borne relapsing fever peak during late summer (Molloy et al, 2015; Fiorito et al, 2017). This peak in cases coincides with the peak seasonal activity period of larval ticks in the Northeast, but occurs later in the year than the peak for nymphal tick activity and earlier than the fall peak activity period for adult ticks (Sonenshine, 1993; Stafford, 2007).…”

In Vitro Susceptibility of the Relapsing-Fever Spirochete Borrelia miyamotoi to Antimicrobial Agents

“…RF Borrelia spirochetes cause a variety of diseases, which are characterized by episodes of high fever separated by periods of relative well-being. The clinical presentation of disease caused by B. miyamotoi, however, appears to differ from that of classical RF, since relapsing-fever episodes have been observed only in 10% of patients infected with B. miyamotoi, and their levels of spirochetemia are calculated to be low (6,7). Since most patients with B. miyamotoi infection are usually treated with antibiotics, this might be an underestimation of the naturally occurring relapses.…”

The ecology of Lyme borreliosis risk : interactions between lxodes ricinus, rodents and Borrelia burgdorferi sensu lato

“…This suggests a potentially higher contribution of larval tick bites to tick-borne relapsing fever in humans compared to larval contribution to Lyme borreliosis. Other studies have previously suggested an important role for larvae in the transmission of B. miyamotoi based on infections coinciding with larval activity and infestation (Barbour et al 2009, Molloy et al 2015. The contribution of larval transmission to rodents and from rodents to larvae to the enzootic life cycle of B.…”