sábado, 1 de octubre de 2011

Humans Infected with Relapsing Fever Spirochete Borrelia miyamotoi, Russia - Vol. 17 No. 10 - October 2011 - Emerging Infectious Disease journal - CDC

 

Volume 17, Number 10—October 2011

Research

Humans Infected with Relapsing Fever Spirochete Borrelia miyamotoi, Russia

Alexander E. Platonov, Ludmila S. Karan, Nadezhda M. Kolyasnikova, Natalya A. Makhneva, Marina G. Toporkova, Victor V. Maleev, Durland Fish, and Peter J. KrauseComments to Author 
Author affiliations: Central Research Institute of Epidemiology, Moscow, Russia (A.E. Platonov, L.S. Karan, N.M. Kolyasnikova, V.V. Maleev); Municipal Clinical Hospital No. 33, Yekaterinburg, Russia (N.A. Makhneva, M.G. Toporkova); Yale School of Public Health and Yale School of Medicine, New Haven, Connecticut, USA (D. Fish, P.J. Krause)
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Abstract

Borrelia miyamotoi is distantly related to B. burgdorferi and transmitted by the same hard-body tick species. We report 46 cases of B. miyamotoi infection in humans and compare the frequency and clinical manifestations of this infection with those caused by B. garinii and B. burgdorferi infection. All 46 patients lived in Russia and had influenza-like illness with fever as high as 39.5°C; relapsing febrile illness occurred in 5 (11%) and erythema migrans in 4 (9%). In Russia, the rate of B. miyamotoi infection in Ixodes persulcatus ticks was 1%–16%, similar to rates in I. ricinus ticks in western Europe and I. scapularis ticks in the United States. B. miyamotoi infection may cause relapsing fever and Lyme disease–like symptoms throughout the Holarctic region of the world because of the widespread prevalence of this pathogen in its ixodid tick vectors.

Borrelia miyamotoi, discovered in Japan in 1995, belongs to the relapsing fever group of Borrelia (1). Relapsing fever borreliae infections are characterized by influenza-like illness and >1 relapse episode of bacteremia and fever. B. miyamotoi is more distantly related to B. burgdorferi, a group of spirochetes that includes B. burgdorferi s.l. strains (B. afzelii; B. garinii; and B. burgdorferi s.s., the causative agent of Lyme disease) (2,3). In Eurasia and North America, B. miyamotoi is found in a small percentage of all species of ixodid tick vectors of B. burgdorferi, including Ixodes persulcatus (1,3,4), I. ricinus (57), I. scapularis (2,3,8,9), and I. pacificus (10). It is transmitted transovarially and transstadially by ticks and coexists with B. burgdorferi (2,3). Recently, we discovered B. miyamotoi in I. persulcatus and I. ricinus ticks in the European and Asian regions of Russia. In these areas, human ixodid tick-borne infections, including those caused by B. afzelii, B. garinii, and viral tick-borne encephalitis virus (TBEV; genus Flavivirus) are endemic and transmitted by the same tick species.

Despite the presence of B. miyamotoi in vector ticks, to our knowledge, human disease caused by this spirochete has not been definitively established. We previously noted presumptive B. miyamotoi infection in residents of central Russia with influenza-like illness but were uncertain whether their clinical manifestations were caused by co-infecting B. burgdorferi s.l. species (1113). To confirm those findings and develop initial estimates of the prevalence and severity of B. miyamotoi infection, we conducted a comparative cohort study. We used improved antibody assays and PCRs to compare the relative frequency and clinical manifestations of B. miyamotoi infection with those of B. garinii infection in Russia and B. burgdorferi infection in the United States.

full-text:
Humans Infected with Relapsing Fever Spirochete Borrelia miyamotoi, Russia - Vol. 17 No. 10 - October 2011 - Emerging Infectious Disease journal - CDC

Thumbnail of Percentage of Ixodes persulcatus (I. p.) and I. ricinus (I. r.) ticks infected with Borrelia miyamotoi in Russia. The number of ticks that were tested is given in parenthesis. Star indicates study location of human B. miyamotoi infection. Figure 1. Percentage of Ixodes persulcatus (I. p.) and I. ricinus (I. r.) ticks infected with Borrelia miyamotoi in Russia. The number of ticks that were tested is given in parenthesis. Star indicates...
Suggested citation for this article: 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 [serial on the Internet]. 2011 Oct [date cited]. http://dx.doi.org/10.3201/eid1710.101474External Web Site Icon
DOI: 10.3201/eid1710.101474

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