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Is Borrelia Miyamotoi a Threat?

Emerging tickborne infection in US

Laboratory findings for Borrelia miyamotoi disease (BMD), a new and emerging infection brought to the US by deer ticks, found 97 BMD cases identified by whole-blood polymerase chain reaction testing among 11,515 patients tested from the northeastern US. Clinical records were analyzed to identify the major features of acute disease. Patients with BMD presented with nonspecific symptoms, including fever, headache, chills, myalgia, and arthralgia. Other findings revealed:

• 24% of patients with BMD were hospitalized.

• Elevated liver enzyme levels, neutropenia and thrombocytopenia were common.

• 16% of patients with BMD were seropositive for IgG and/or IgM antibody to B. miyamotoi rGlpQ.

• 78% of patients with BMD has seropositive convalescent specimens.

Citation: Molloy PJ, Telford III SR, Chowdri HR, et al. Borrelia miyamotoi disease in the northeastern United States: A case series. Ann Inter Med. 2015;163(2):91-98.

Commentary: Borrelia miyamotoi is transmitted by the Ixodes deer tick, the same tick that transmits Borrelia burgdorferi, the agent that causes Lyme disease. B. Miyamotoi presents with fever, chills, headache, neck stiffness, fatigue, myalgias and arthralgias. Bloodwork can show leukopenia, thrombocytopenia, and elevated LFTs. Infection is most common when ticks are active during the late spring and summer. Unlike Lyme disease, infection with B. miyamotoi does not appear to cause persistent infection or cause long-term complications. Treatment is with doxycycline or amoxicillin which speeds resolution of infection1. —Neil Skolnik, MD

1. Barbour AG. Borrelia miyamotoi infection. UpToDate 2015.