What Is the Borrelia Miyamotoi Infection?

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Borrelia MiyamotoiBorrelia miyamotoi (B. miyamotoi) is a spirochete bacterium that can be passed on to humans through a deer tick. Borrelia miyamotoi disease (BMD) is a tick-borne infection that can cause symptoms similar to, or even worse than Lyme disease, such as fever, headaches, and unsightly rashes.

This disease first surfaced in the northeastern regions of the United States in 2013 and is believed to be transmitted through larval tick bites.

Symptoms of Borrelia Miyamotoi Disease

In most cases, BMD causes flu-like symptoms, including chills, headaches, vomiting, neck stiffness, muscle aches, rashes, and fever. A high fever can bring on a host of other symptoms, including respiratory and cardiac problems, complications with pregnancy, and even death.

The fever will typically last for a few days; it will be followed by a short period of relief, followed by another episode of the fever. This process could occur anywhere between one to four times.

People who don’t get treated can develop chronic fatigue, joint and muscle pain, or even joint deterioration. Other long-term effects include inflammation of the iris, cranial nerve disorder, and other possible neuropathies.

B. Miyamotoi 101

  • Researchers have not been able to directly pinpoint the full geographic distribution of human B. miyamotoi infections.
  • B. miyamotoi can be compared to a burrowing organism, which suggests that it prefers tissue rather than blood.
  • The University of Tennessee reported that in 2009, during fall hunting season, 58% of turkeys that were harvested tested positive for B. miyamotoi, with a greater percentage of the bacteria detected in tissues rather than blood.
  • B. miyamotoi, like most infections, can become more serious if contracted by an elderly individual or an individual with a compromised immune system.

Cause and Diagnosis of B. Miyamotoi

In most cases, B. miyamotoi is transmitted to humans from a larval tick bite; this transovarial transmission is the process where the parent tick transmits the disease to the offspring.

Considering the symptoms of B. miyamotoi are very similar to the ones found in Lyme disease (i.e. high fever, fatigue, and headaches), a proper diagnosis will require blood smear tests.

People who have been infected with B. miyamotoi are likely to test negative for Lyme disease—unless they have also been infected with Lyme disease. This is why doctors who only test for Lyme disease might not correctly diagnose B. miyamotoi.

If you develop a fever and have recently traveled to or reside in a region where Lyme disease is prevalent (i.e. in North America or in Eurasian countries during tick season), consider getting tested for the B. miyamotoi infection. If you believe you have been infected with B. miyamotoi but are denied treatment at a clinic, then visit a tertiary care center (such as a university hospital) and ask to be tested specifically for B. miyamotoi.

Why Are We Just Hearing About This Now?

B. miyamotoi was first discovered in ticks and mice in 1995. In 2011, Dr. Durland Fish discovered it in Connecticut, but he was refused a study grant to further his research. In 2011, the Russians discovered it and decided to collaborate with a Yale team to show how the disease affects humans. Keep in mind that the patients who participated in the 2011 study were Russian—BMD first surfaced in northeastern U.S. in 2013.

B. Miyamotoi Treatment

The most common antibiotic prescribed for people infected with B. miyamotoi is doxycycline. It’s recommended that patients take 100 mg orally every 12 hours, for anywhere from seven to 14 days. This medication has been effective with reducing fevers, often within five days of taking it. Another common antibiotic is intravenous ceftriaxone (two grams, once a day), provided that it is taken for two weeks.

These antibiotics are more commonly used to treat Lyme disease, but they are also expected to work for fighting B. miyamotoi as well.

B. Miyamotoi Prevention

There has been no vaccine developed or approved for the infection or any other Borrelia infection. The most effective ways to prevent B. miyamotoi infections are similar to the ones that are used for Lyme disease: aim to avoid tick bites. Ticks can generally be found in forests, lakes, or areas where wildlife is present.

Sources:
Krause, P.J. et. al., “Borrelia miyamotoi infection in nature and in humans,” Clinical Microbiology and Infection 2015; doi: 10.1016/j.cmi.2015.02.006.
“New Tick Borne Disease Discovered,” Personal Consult web site; http://www.personalconsult.com/posts/new-tick-borne-disease.html, last accessed August 17, 2015.
“9 things you need to know about Borrelia miyamotoi,” TheTickThatBitMe.com, February 18, 2013; http://thetickthatbitme.com/2013/02/18/9-things-you-need-to-know-about-borrelia-miyamotoi/.
“Widespread Borrelia miyamotoi tick-borne fever found in US,” Medscape web site, June 12, 2015; http://www.medscape.com/viewarticle/846337#vp_1.

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