989. Human Infection with the Relapsing Fever Spirochete Borrelia miyamotoi
Session: Poster Abstract Session: Clinical Studies of Bacterial Infection
Saturday, October 22, 2011
Room: Poster Hall B1
Handouts
  • *1. Krause poster IDSA.pdf (1.5 MB)
  • Background: Borrelia miyamotoi belongs to a relapsing fever group Borrelia that is distantly related to B.burgdorferi and transmitted by the same hard-body tick species. In the northeastern US, about 15% of all spirochetes carried by Ixodes scapularis consist of B.miyamotoi but human disease caused by this spirochete has never been definitively established. We previously noted presumptive B.miyamotoi infection in residents of central Russia but were uncertain whether their symptoms were due to coinfecting B.burgdorferi sensu lato species.

    Methods: We carried out a comparative cohort study using improved antibody and PCR assays to compare the relative frequency and clinical manifestations of B.miyamotoi infection with those of infections caused by B.garinii in Russia and B.burgdorferi in the US. Patients admitted to hospital in Yekaterinburg City, Russia from May through August 2009 for suspected tick borne infection were enrolled in this study. Subjects were admitted because of concern about viral tick-borne encephalitis or acute borreliosis that are managed with hospital admission if moderate or severe. Subjects with clinical and laboratory evidence of B.burgdorferi infection were enrolled in a tick-borne diseases study in the northeastern US from 1991 through 2008. 

    Results: Of the 302 Russian patients admitted to hospital with suspected tick-borne illness, 46 had B.miyamotoi infection with amplifiable B.miyamotoi DNA and anti-borrelial IgM antibody in their blood. Forty of these subjects had IgM seroconversion in acute and convalescent sera and all 18 who were tested for borrelia IgG seroconverted. All B. miyamotoi patients experienced a flu-like illness with fever as high as 39.5°C. Five (11%) suffered relapsing febrile illness and four (9%) had an erythema migrans rash. The 46 B.miyamotoi patients experienced significantly more systemic symptoms than the 21 B.garinii and 92 B.burgdorferi patients. The B.miyamotoi infection rate of I.persulcatus ticks ranged from 1 to 16%, similar to those of I.ricinus in Europe and I.scapularis in the US.

    Conclusion: B.miyamotoi infection may be problematic because of the widespread prevalence of this spirochete in Lyme disease tick vectors and the associated episodes of disease.


    Subject Category: C. Clinical studies of bacterial infections and antibacterials including sexually transmitted diseases and mycobacterial infections (surveys, epidemiology, and clinical trials)

    Alexander Platonov, PhD, DSci1, Ludmila Karan1, Nadezhda Kolyasnikova, PhD1, Natalya Makhneva2, Marina Toporkova, PhD2, Victor Maleev, MD, PhD1, Durland Fish, PhD3 and Peter Krause, MD3, (1)Central Research Institute of Epidemiology, Moscow, Russia, (2)Municipal Clinical Hospital № 33, Yekaterinburg, Russia, (3)Yale School of Public Health and Yale School of Medicine, New Haven, CT

    Disclosures:

    A. Platonov, None

    L. Karan, None

    N. Kolyasnikova, None

    N. Makhneva, None

    M. Toporkova, None

    V. Maleev, None

    D. Fish, None

    P. Krause, None

    Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.