Daniel Cameron, MD, MPH

Borrelia miyamotoi disease can be added to list of traveler’s concerns

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Dr. Daniel Cameron
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Doctors described a case of BMD in a previously healthy 63-year-old American man living in Japan. “He reported being bitten by ticks several times while staying with his family at his summer house in the state of Minnesota in the USA from July 25 to August 9, 2013,” according to Oda from the Division of Infectious Diseases, Musashino Red Cross Hospital, Japan. [1]

He presented with a 10-day history of malaise, headache, myalgia, and arthralgia following his return from Minnesota. He presented with a high fever (39.2 C), relative bradycardia (77 beats/min), erythema migrans, slightly elevated aspartate aminotransferase and alanine aminotransferase levels (39 IU/L and 77 IU/L, respectively), and elevated C-reactive protein level (7.73 mg/dL).

The man was diagnosed with BMD by seroreactivity to recombinant glycerophosphodiester phosphodiesterase (rGlpQ). rGlpQ was described in a case series by Molloy from IMUGEN in the Annals of Internal Medicine. [2] “The accuracy of rGlpQ serodiagnosis was originally designated by Schwan et al. [3], and is an alternative method when bacterial DNA is not detected,” according to Oda.

He was also diagnosed with Lyme disease based on the rash and three IgM bands: 24 kDa (OspC), 39 kDa (BmpA), and 41 kDa (Fla). The authors did not mention whether they looked for other tick-borne illnesses reported in Minnesota such as Babesia, Ehrlichia and Anaplasmosis.

“This case suggests that BMD should be considered in febrile travelers returning from the Northeastern and Midwestern regions of the United States,” states Oda “and that BMD and Lyme disease co-infection should be considered to detect cases of imported BMD.”

The authors summarize the literature on treatment of BMD. “Treatment for uncomplicated BMD is generally doxycycline (100 mg twice a day) for 7- 14 days,” explains Oda. “Amoxicillin, cefuroxime, and macrolide also may be effective.” [4] Oda also included a case of BMD with meningoencephalitis in an immunocompromised patient who failed 2 weeks of doxycycline that responded to 30 days of intravenous penicillin G therapy. [5]

The 63-year-old American traveler to Minnesota gradually improved over 14 days on doxycycline. The authors’ case report adds BMD disease to the growing list of traveler’s concerns following a tick bite.

 

References:

  1. Oda R, Kutsuna S, Sekikawa Y, Hongo I, Sato K, Ohnishi M, Kawabata H: The first case of imported Borrelia miyamotoi disease concurrent with Lyme disease. J Infect Chemother 2017.
  2. Molloy PJ, Telford Iii SR, Chowdri HR, Lepore TJ, Gugliotta JL, Weeks KE, Hewins ME, Goethert HK, Berardi VP: Borrelia miyamotoi Disease in the Northeastern United States: A Case Series. Ann Intern Med 2015.
  3. Schwan TG, Schrumpf ME, Hinnebusch BJ, Anderson DE, Jr., Konkel ME: GlpQ: an antigen for serological discrimination between relapsing fever and Lyme borreliosis. J Clin Microbiol 1996, 34(10):2483-2492.
  4. Krause PJ, Fish D, Narasimhan S, Barbour AG: Borrelia miyamotoi infection in nature and in humans. Clin Microbiol Infect 2015.
  5. Gugliotta JL, Goethert HK, Berardi VP, Telford SR, 3rd: Meningoencephalitis from Borrelia miyamotoi in an immunocompromised patient. N Engl J Med 2013, 368(3):240-245.

 

Comments

2 responses to “Borrelia miyamotoi disease can be added to list of traveler’s concerns”

  1. Wayne Stevens Avatar
    Wayne Stevens

    Is it possible that Burgdafori has always been present and that ticks were bioengineered with Myamotoi, Rickettsias and a viral component.
    Even the Limerex vaccine may have been designed to confuse because Myamotoi wouldn’t show up as Lyme Disease (Burgdafori).
    Based on my tick research mother ticks don’t transmit Lyme to their offspring. I was always told ticks are born sterile however I’ve since learned that ticks can pass Myamotoi to their offspring.
    Burgdafori would still be spread congenitally in mice,critters, humans while Myamotoi would be spread from Mother ticks to their offspring.
    Throw engineered Myamotoi in with Burgdafori and you get 3 scenarios.
    1. Get bit by a Myamotoi infected tick which hasn’t fed on a Burgdafori host. You would have Lyme like symptoms but will never test pos for Lyme.
    2. Get bit by a Myamotoi infected tick which has fed on a Burgdafori host. You would acquire a more virulent engineered illness.
    3. Get bit by a sterile tick that fed on a Burgdafori host. You would acquire an illness that appears more like what we have seen for centuries.
    The speed of nerve and brain dysfunction brought on Neurological illnesses much slower.
    Now we are seeing Neurological illnesses start in 20-30 yr olds. It used to be 50 and up.
    This leads me to believe that Lyme basically was always here.
    Based on age it seems multiple strains of Borrelia and bioengineering have basically sped the slow death two fold.

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  2. Karen Avatar
    Karen

    It is being called Relapsing Fever Group in California by CDPH. They have found it in ticks at a rate of 1 B miyamotoi to 4 B burgdorferi in my county. Of course, no one is being tested for it, so human cases are going undiagnosed and untreated. They rarely cause EM rash according to the early human case studies.

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