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Ahead of Print -Borrelia miyamotoi sensu lato Seroreactivity and Seroprevalence in the Northeastern United States - Volume 20, Number 7—July 2014 - Emerging Infectious Disease journal - CDC

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Ahead of Print -Borrelia miyamotoi sensu lato Seroreactivity and Seroprevalence in the Northeastern United States - Volume 20, Number 7—July 2014 - Emerging Infectious Disease journal - CDC

Volume 20, Number 7—July 2014


Borrelia miyamotoi sensu lato Seroreactivity and Seroprevalence in the Northeastern United States

Peter J. KrauseComments to Author , Sukanya Narasimhan, Gary P. Wormser, Alan G. Barbour, Alexander E. Platonov, Janna Brancato, Timothy Lepore, Kenneth Dardick, Mark Mamula, Lindsay Rollend, Tanner K. Steeves, Maria Diuk-Wasser, Sahar Usmani-Brown, Phillip Williamson, Denis S. Sarksyan, Erol Fikrig, Durland Fish, and the Tick Borne Diseases Group
Author affiliations: Yale School of Public Health, New Haven, Connecticut, USA (P.J. Krause, J. Brancato, L. Rollend, T.K. Steeves, M. Diuk-Wasser, D. Fish)Yale School of Medicine, New Haven (P.J. Krause, S. Narasimhan, M. Mamula, E. Fikrig)New York Medical College, Valhalla, New York, USA (G.P. Wormser);University of California, Irvine, California, USA (A.G. Barbour);Central Research Institute of Epidemiology, Moscow, Russia (A.E. Platonov)Nantucket Cottage Hospital, Nantucket, Massachusetts, USA (T. Lepore)Mansfield Family Practice, Mansfield, Connecticut, USA (K. Dardick)L2 Diagnostics, LLC, New Haven (S. Usmani-Brown)Creative Testing Solutions, Tempe, Arizona, USA (P. Williamson)State Medical Academy, Izhevsk, Russia (D.S. Sarksyan)


Borrelia miyamotoi sensu lato, a relapsing fever Borrelia sp., is transmitted by the same ticks that transmit B. burgdorferi (the Lyme disease pathogen) and occurs in all Lyme disease–endemic areas of the United States. To determine the seroprevalence of IgG against B. miyamotoi sensu lato in the northeastern United States and assess whether serum from B. miyamotoi sensu lato–infected persons is reactive to B. burgdorferi antigens, we tested archived serum samples from area residents during 1991–2012. Of 639 samples from healthy persons, 25 were positive for B. miyamotoi sensu lato and 60 for B. burgdorferi. Samples from ≈10% of B. miyamotoi sensu lato–seropositive persons without a recent history of Lyme disease were seropositive for B. burgdorferi. Our resultsA suggest thatA human B. miyamotoiA sensu latoA infection may be common in southern New England and that B. burgdorferi antibody testing is not an effective surrogate for detecting B. miyamotoisensu lato infection.
Relapsing fever, an arthropod-borne infection caused by several Borrelia spp. spirochetes, is transmitted by ticks and lice (1,2). In 1995, Fukunaga et al. (3) discovered a novel relapsing fever spirochete in the hard-bodied (ixodid) tick Ixodes persulcatus and named it Borrelia miyamotoi. This discovery greatly expanded the potential geographic range of relapsing fever borreliae for humans. Before this finding, only soft-bodied ticks were known to transmit tick-borne relapsing fever spirochetes to humans. In 2001, a related spirochete was detected in I. scapularis ticks in the northeastern United States (4); this and similar organisms have been designated B. miyamotoi sensu lato to distinguish them from the B. miyamotoi sensu stricto isolates from Japan (5). A subsequent study showed that ticks in 15 states in the northeastern and northern midwestern regions of the United States are infected with B. miyamotoi sensu lato and have an average prevalence of infection of 1.9% (range 0–10.5%) (6). B. miyamotoi sensu lato has now been found in all tick species known to be vectors of Lyme disease, including I. pacificus in the western United States, I. ricinus in Europe, and I. persulcatus and I. ricinus in Russia (79). The first human cases of B. miyamotoi sensu lato infection were reported from central Russia in 2011 (9). Several reports of B. miyamotoi sensu lato infection in humans have subsequently been published, including 3 in the United States, 1 in Europe, and 1 in Russia (1014). Some of these reports suggest that B. miyamotoi sensu lato infection causes a nonspecific, virus-like illness. B. miyamotoi sensu lato and B. burgdorferi, the agent of Lyme disease, share several antigens that might cause cross-reactivity during serologic testing, which could lead to a misdiagnosis.
There are few data on the seroprevalence of B. miyamotoi sensu lato infection. To increase knowledge of the seroprevalence of this infection, we used assays for antibodies against B. miyamotoi sensu lato glycerophosphodiester phosphodiesterase (GlpQ), a protein that is absent from all Lyme disease Borrelia species (15), for evaluation of >1,000 archived serum samples from persons living in a Lyme disease–endemic region of the United States. We also performed standard 2-tiered testing for B. burgdorferi antibodies (16). Our aim was to compare the seroprevalence of B. miyamotoi sensu lato with that of B. burgdorferi. We also sought to determine whether persons seropositive for B. miyamotoi sensu lato would also have positive results for standard B. burgdorferi antibody testing.

Dr Krause is a Senior Research Scientist in the Department of Epidemiology of Microbial Diseases at the Yale School of Public Health and the Yale School of Medicine. His research focuses on tick-borne diseases, especially those caused by Borrelia miyamotoiand Babesia microti.


Members of the Tick Borne Diseases Group: Michel Ledizet and Mary Lou Breitenstein (L2 Diagnostics, LLC, New Haven, Connecticut, USA); Thomas Clay and Kathleen Stanton (Brimfield Family Health Center, Brimfield, Massachusetts, USA); Joseph Gadbaw (Lawrence and Memorial Hospital, New London, Connecticut); Janice Miller (Island Medical Center, Block Island, Rhode Island, USA); Ludmila S. Karan (Central Research Institute of Epidemiology, Moscow, Russia); and Kristen Brao (Yale School of Public Health, New Haven).
We thank Francesica Tizard at the Yale School of Public Health for help with manuscript preparation.
This work was supported by grants (AI088079 to D.F. and P.J.K. and AI100236 to A.G.B.) from the National Institute of Allergy and Infectious Diseases, National Institutes of Health. Additional support was provided by the Gordon and Llura Gund Foundation and the G. Harold and Leila Y. Mathers Charitable Foundation.


  1. Barbour AG. Relapsing fever. In: Goodman JL, Dennis DT, Sonenshine DE, editors. Tick-borne diseases of humans. Washington (DC): ASM Press; 2005.
  2. Dworkin MSSchwan TGAnderson DETick-borne relapsing fever in North America. Med Clin North Am2002;86:41733 . DOIExternal Web Site Icon
  3. Fukunaga MTakahashi YTsuruta YMatsushita ORalph DMcClelland MGenetic and phenotypic analysis of Borrelia miyamotoi sp. nov., isolated from the ixodid tick Ixodes persulcatus, the vector for Lyme disease in Japan. Int J Syst Bacteriol1995;45:80410 . DOIExternal Web Site Icon
  4. Scoles GAPapero MBeati LFish DA relapsing fever group spirochete transmitted byIxodes scapularis ticks. Vector Borne Zoonotic Dis2001;1:2134 . DOIExternal Web Site Icon
  5. Bunikis JTsao JGarpmo UBerglund JFish DBarbour AGTyping of Borrelia relapsing fever group strains. Emerg Infect Dis2004;10:16614 . DOIExternal Web Site Icon
  6. Barbour AGBunikis JTravinsky BHoen AGDiuk-Wasser MAFish DNiche partitioning of Borrelia burgdorferi and Borrelia miyamotoi in the same tick vector and mammalian reservoir species. Am J Trop Med Hyg2009;81:112031DOIExternal Web Site Icon
  7. Mun JEisen RJEisen LLane RSDetection of a Borrelia miyamotoi sensu lato relapsing-fever group spirochete from Ixodes pacificus in California. J Med Entomol2006;43:1203DOIExternal Web Site Icon
  8. Richter DSchlee DBMatuschka FRRelapsing fever–like spirochetes infecting European vector tick of Lyme disease agent. Emerg Infect Dis2003;9:697701DOIExternal Web Site Icon
  9. Platonov AEKaran LSKolyasnikova NMMakhneva NToporkova MGMaleev VV,Humans infected with the relapsing fever spirochete Borrelia miyamotoi, Russia. Emerg Infect Dis2011;17:181623DOIExternal Web Site Icon
  10. Gugliotta JLGoethert HKBerardi VPTelford SRMeningoencephalitis due to Borrelia miyamotoi in an elderly immunocompromised patient. N Engl J Med2013;368:2405 . DOIExternal Web Site Icon
  11. Krause PJNarasimhan SWormser GPRollend LFikrig ELepore THuman Borrelia miyamotoi infection in the United States. N Engl J Med2013;368:2913 . DOIExternal Web Site Icon
  12. Chowdri HRGugliotta JLBerardi VGoethert HMolloy PJSterling SLBorrelia miyamotoipresenting as human granulocytic anaplasmosis. A case report. Ann Intern Med.2013;159:217DOIExternal Web Site Icon
  13. Hovius JWde Wever BSohne MBrouwer MCoumou JWagemakers AA case of meningoencephalitis by the relapsing fever spirochete Borrelia miyamotoi in Europe.Lancet2013;382:658DOIExternal Web Site Icon
  14. Sarksyan DSPlatonov AEKaran LSMalinin IEKhaliltova LIShakhov VIClinical presentation of "new" tick-borne borreliosis caused by Borrelia miyamotoi [In Russian].Ter Arkh2012;84:3441 .
  15. Schwan TGSchrumpf MEHinnebusch BJAnderson DEKonkel MEGlpQ: an antigen for serological discrimination between relapsing fever and Lyme borreliosis. J Clin Microbiol.1996;34:248392 .
  16. Krause PJMcKay KGadbaw JChristianson DCloster LLepore TIncreasing health burden of human babesiosis in endemic sites. Am J Trop Med Hyg2003;68:4316 .
  17. Horowitz HWAguero-Rosenfeld MEHolmgren DMcKenna DSchwartz ICox MELyme disease and human granulocytic anaplasmosis coinfection: impact of case definition on coinfection rates and illness severity. Clin Infect Dis2013;56:939 . DOIExternal Web Site Icon
  18. Barbour AGJasinskas AKayala MADavies DHSteere ABaldi PA genome-wide proteome array reveals a limited set of immunogens in natural infections of humans and white-footed mice with Borrelia burgdorferi. Infect Immun2008;76:337489 . DOIExternal Web Site Icon
  19. Hue FGhalyanchi Langeroudi ABarbour AG. Chromosome sequence of Borrelia miyamotoi, an uncultivable tick-borne agent of human infection. Genome Announc.2013;1:e00713–13.External Web Site Icon
  20. Liang FTSteere ACMarques ARJohnson BJMiller JNPhilipp MTSensitive and specific serodiagnosis of Lyme disease by enzyme-linked immunosorbent assay with a peptide based on an immunodominant conserved region of Borrelia burgdorferi VlsE. J Clin Microbiol1999;37:39906 .
  21. Magnarelli LAMeegan JMAnderson JFChappell WAComparison of an indirect fluorescent-antibody test with an enzyme-linked immunosorbent assay for serological studies of Lyme disease. J Clin Microbiol1984;20:1814 .
  22. Dressler FWhalen JAReinhardt BNSteere ACWestern blotting in the serodiagnosis of Lyme disease. J Infect Dis1993;167:392400DOIExternal Web Site Icon
  23. Bacon RMBiggerstaff BJSchreifer MGilmore RDPhilipp MTSteere ACSerodiagnosis of Lyme disease by kinetic enzyme-linked immunosorbent assay using recombinant VlsE1 or peptide antigens of Borrelia burgdorferi compared with 2-tiered testing using whole-cell lysates. J Infect Dis2003;187:118799DOIExternal Web Site Icon
  24. Magnarelli LAAnderson JFJohnson RCCross-reactivity in serological tests for Lyme disease and other spirochetal infections. J Infect Dis1987;156:1838DOIExternal Web Site Icon
  25. Magnarelli LALawrenz MNorris SJFikrig EComparative reactivity of human sera to recombinant VlsE and other Borrelia burgdorferi antigens in class-specific enzyme-linked immunosorbent assays for Lyme borreliosis. J Med Microbiol2002;51:64955 .
  26. Johnson STCable RGTonnetti LSpencer BRios JLeiby DASeroprevalence of Babesia microti in blood donors from Babesia-endemic areas of the northeastern United States: 2000 through 2007. Transfusion2009;49:257482 . DOIExternal Web Site Icon
  27. Krause PJTelford SSpielman ASikand VJRyan RChristianson DConcurrent Lyme disease and babesiosis: evidence for increased severity and duration of illness. JAMA.1996;275:165760DOIExternal Web Site Icon
  28. Krause PJMcKay KThompson CASikand VJLentz RLepore TDisease-specific diagnosis of coinfecting tick-borne zoonoses: babesiosis, human granulocytic ehrlichiosis, and Lyme disease. Clin Infect Dis2002;34:118491DOIExternal Web Site Icon
  29. Ackermann RKabatzki JBoisten HPSteere ACGrodzicki RLHartung SIxodes ricinusspirochete and European erythema chronicum migrans disease. Yale J Biol Med.1984;57:57380 .
  30. Centers for Disease Control and PreventionCase definitions for infectious conditions under public health surveillance. MMWR Recomm Rep1997;46(RR-10):155 .
  31. Zhang JRHardham JMBarbour AGNorris SJAntigenic variation in Lyme disease borreliae by promiscuous recombination of VMP-like sequence cassettes. Cell.1997;89:27585DOIExternal Web Site Icon
  32. Salkeld DJCinkovich SNieto NCTick-borne pathogens in northwestern California, USA[letter]Emerg Infect Dis2014;20:4934DOIExternal Web Site Icon



Suggested citation for this article: Krause PJ, Narasimhan S, Wormser GP, Barbour AG, Platonov AE, Brancato J, et al. Borrelia miyamotoi sensu lato seroreactivity and seroprevalence in the northeastern United States. Emerg Infect Dis. 2014 July [date cited].http://dx.doi.org/10.3201/eid2007.131587External Web Site Icon
DOI: 10.3201/eid2007.131587
1Members of the Tick Borne Diseases Group are listed at the end of this article.

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