LYME SCI: B. miyamotoi has been in California ticks for a long time
Like forensic detectives, using a bank of frozen blood serum from the 1980s, tick researchers from both the west and east coasts set out to determine how prevalent Borrelia miyamotoi infection is in California. What they discovered should set off more than a few alarms.
B. miyamotoi is a spiral-shaped bacterium in the same genus as Borrelia burgdorferi, the agent of Lyme disease. But it is most closely related to the group of relapsing fever Borrelia spirochetes. It has recently been recognized as causing a form of borreliosis that is similar to Lyme disease—Borrelia miyamotoi disease (BMD).
B. miyamotoi is transmitted by the same hard-bodied ticks that carry Lyme disease—the blacklegged or deer tick (Ixodes scapularis) and the western blacklegged tick (Ixodes pacificus).
The symptoms of BMD are similar to Lyme disease but generally more severe, with the addition of a relapsing fever, and the absence of a typical bull’s-eye rash. Because BMD is not a reportable disease in the US, there is very little information about its symptoms or prevalence.
For this study, the researchers were given access to a biobank of 101 blood samples collected from a rural community in Mendocino County, California, after an outbreak of Lyme disease in the late 1980s. The area has since been the focus of many tick studies and is known for high prevalence of ticks that carry both BMD and Lyme disease.
Three quarters of the people in the study reported frequent tick bites in the one to two years prior to the blood draw. Later, a confirmatory blood test showed that 79% had antibodies to tick saliva—a rate nearly three times that of residents of Block Island, Rhode Island (29%), where Lyme disease is highly endemic.
For the BMD screening, researchers used two different methods to look for evidence of prior exposure to B. miyamotoi—a two-step glycerophosphodiester phosphodiesterase enzyme-linked immunosorbent (rGlpQ) assay and a whole-cell lysate (WCL) assay.
Twenty-six of the 101 samples were reactive for BMD. [Note: the B. miyamotoi GlpQ assay is not affected by Lyme disease infection because B. burgdorferi does not produce GlpQ antigen.]
The samples were also tested for Borrelia hermsii and Borrelia burgdorferi, to examine the possibility of cross-reactivity and/or dual infection.
The researchers feel there is probable cause of BMD infection for several reasons:
- Studies showing 0.5% to 15% of Ixodes pacificus ticks carry B. miyamotoi infection in Northern California,
- B. miyamotoi is passed from parent to offspring (transovarial transmission), increasing risk of infection from nymphal ticks,
- Mild climates allow for nearly year-round activity of ticks in California.
“No human cases of B. miyamotoi previously have been reported from the western United States even though I. pacificus ticks in northern California have a spirochete-infection prevalence similar to or exceeding that of I. scapularis ticks in the Northeast and upper Midwest,” according to the authors.
The authors go on to warn, “Healthcare professionals in the far-western United States should be aware that B. miyamotoi disease may occur throughout the geographic distribution of I. pacificus and that improved relapsing fever group spirochete antibody assays are urgently needed.”
In summary, while B. miyamotoi is considered an “emerging” infectious disease, it is not new to California. The fact that there are no previously reported cases is because 1) until recently there have been no commercially available tests and 2) since BMD is not a reportable disease, nobody collects such information.
This study highlights the pressing need to develop better diagnostic tests capable of detecting all tick-borne diseases–and to collect the results of those tests in a way that’s accessible to the public.
Click here to read the open access journal article.
LymeSci is written by Lonnie Marcum, a Licensed Physical Therapist and mother of a daughter with Lyme. Follow her on Twitter: @LonnieRhea Email her at: lmarcum@lymedisease.org .
Can this be transmitted through sand fleas?
I’m not aware that any researchers have ever looked into whether B. miyamotoi is transmissible via sand fleas.–editor
I don’t believe anyone cares…..
I believe that I contracted the spirochete B. miyamotoi in Mendocino Co in June 2013. About two weeks after visiting Lenard Lake, I developed a fever between 103 and 104 degrees, complete exhaustion, body ache, and other flu like symptoms. I thought that I had a severe flu bug and took aspirin. The first symptoms showed up on a Wednesday. I was no better by the following Monday and I went to a doctor. At the time I thought that I might have had a prostate or bladder infection because of genital pains. I was given an antibiotic to treat such infections and given blood tests. One of the tests showed a high positive reaction for spirochete infection. It also indicated that both my kidneys and liver were not functioning and was told not to take aspirin. By the following Friday I was showing no improvement. Because of the high positive spirochete reaction, I was tested for syphilis and Lyme’s disease both of which came out negative. So the medical consensus was that I had some kind of virus. However I am a biologist and I had a good friend who was also a biologist. My friend came across information on B. miyamotoi and we both researched it. We found that my symptoms were consistent with those caused by B. miyamotoi which we read responded well to the antibiotics used for early Lyme’s treatment. So I told my doctor that I wanted to start a doxycycline regiment. Within two days of the start of the treatment, my fever broke and never rose much above 100 after that, but I developed sever Jarvis/Hexheimer reaction with a full body inflammation including my eyes. My feet and legs more than doubled in size. A lost all feeling in feet and legs ie neuropathy. To walk a 100 feet or so to get to the doctor was extremely difficult. I had little strength and no endurance. After the first 10 days of doxycycline, I told my doctor that I wanted another 10 days just to be sure of getting rid of all spirochetes. It seems that the doxycycline did get rid of the infection, but my full recovery took almost three years. Severe joint pains, inability to sleep through the night and overall exhaustion. I lost almost 20 pounds because I had little appetite and small portions at a meal were all that I could manage.
Just recently when talking to my doctor about this episode, she told me I was the sickest patient that she has ever treated and that both she and the other doctor that first saw me were not sure that they could save me. And that I was her only patient that diagnosed and treated their own symptoms. At the time when she began the doxycycline treatment, she told me that she probably shouldn’t be doing that, but she had no better ideas and so went along with me. I was very fortunate to have had her as my doctor. I presented her with the information that I had found on B. Miyamotoi which she read. In the meantime she sent me to a CDC doctor who told me that I did not have a spirochete infection because they do not occur in California and the the positive spirochete reaction was a falls positive.
Along with being a biologist I am also a statistician. It is easy to get falls negatives, because it is easy to miss something that is actually present. But it is rare to get false positives because you can not find something that is not present. Falls positives would be caused by cross contamination which seems highly unlikely for a positive spirochete reaction.
The complete lack of interest and the utter hubris of some doctors is deplorable and despicable. They can not think for themselves but simply follow the crowd. If the crowd believes there is no Lyme’s disease in California, then it must be true even if California ticks are found to carry over 7 different spirochete species including B. burgdorfer and miyamotoi.
When I went back to my doctor after several months, she was convinced that I had a spirochete infections and told me that now she would be able to recognize such infections should they show up and know how to treat them.
would be interesting to test those samples for afzelli and garini too.