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. Krause , 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)
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 (7–9). 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 (10–14). 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.
- Figure 1. Polyacrylamide gel electrophoresis purification (A) and Western blot analysis (B) of recombinant glycerophosphodiester phosphodiesterase (rGlpQ)A) Coomassie blue staining of purified Borrelia miyamotoi sensu lato rGlpQ (lane 1) and of...
- Figure 2. Western blot reactivity to recombinant Borrelia miyamotoi glycerophosphodiester phosphodiesterase in serum samples from 5 Borrelia miyamotoi sensu lato–seropositive patients in the northeastern United States, 1991–2012Numbers at the top of...
- Table 1. Assay results for patient samples seroreactive to Borrelia miyamotoi sensu lato antigen, northeastern United States, 1991�?"2012
- Table 2. Number of false-positive Borrelia burgdorferi assay results for participants in various relapsing fever studies
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/eid2007.131587
1Members of the Tick Borne Diseases Group are listed at the end of this article.