667. An emerging tick-borne disease in Long island, New York: Relapsing fever caused by Borrelia miyamotoi.
Session: Poster Abstract Session: Public Health: Epidemiology and Outbreaks
Thursday, October 4, 2018
Room: S Poster Hall
Posters
  • B miyamotoi poster IDSA LAM Oct 2018.pdf (519.9 kB)
  • Background: Suffolk County (Long Island, NY) reports annually the highest absolute number of tick-borne diseases in NY. A new Borrelia species, Borrelia miyamotoi which causes a relapsing fever, has been reported in NY recently. The aim of this study was to identify the number of cases of B. miyamotoi diagnosed in Suffolk county.

    Methods: A retrospective chart review was performed in Stony Brook (SB) Medicine hospitals, SB University Hospital (the only tertiary medical center in Suffolk County) and Southampton Hospital (a major hospital in the east end of Suffolk County). Laboratory records were queried for a positive B. miyamotoi PCR test from blood or a positive IgG antibody with a B. miyamotoi-specific EIA that utilizes a recombinant GlpQ antigen (both tests performed in a commercial laboratory).

    Results: 28 cases were positive for serology (IgG EIA;n=19) or PCR (n=9). None of the IgG-positive cases had a positive PCR result indicating that individuals were likely exposed to B. miyamotoi in the past. Of the 9 PCR-positive cases (median age:67 years), 8 were men, 3 were diagnosed in the outpatient clinic (33.3%) and 6 were diagnosed through the emergency department and required hospitalization (66.6%). Thrombocytopenia and transaminitis were common findings. Two-thirds of these 9 cases were diagnosed in the period of 2016-2017 and one-third in the period, 2013-2015 (p=0.17).

    Conclusion: An increasing number of cases of B. miyamotoi were observed in Suffolk County during 2013-2017 and two-thirds required hospitalization. The real burden of this tick borne disease in Suffolk County and the rest of the state is unknown.

    Table 1. Clinical-demographics features of B. miyamotoi cases diagnosed by PCR blood test.

    Year of

    presentation

    Age

    (years)

    Gender

    Symptoms

    Leukocytes

    (/mm3)

    Hemoglobin

    (g/dL)

    Platelets

    (/mm3)

    Creatinine

    (mg/dL)

    AST

    (U/L)

    ALT

    (U/L)

    2013

    74

    M

    N/A

    4600

    14.2

    154,000

    0.7

    21

    28

    2015

    67

    F

    Flu-like syndrome

    5500

    14.7

    260,000

    0.8

    33

    23

    2015

    64

    M

    Flu-like syndrome

    3600

    14.1

    109,000

    0.7

    65

    74

    2016

    32

    M

    N/A

    3000

    15.6

    166,000

    1

    98

    65

    2016

    68

    M

    N/A

    N/A

    N/A

    N/A

    N/A

    20

    18

    2016

    74

    M

    Flu-like syndrome and vomiting

    6800

    15.6

    51,000

    3.1

    212

    165

    2017

    90

    M

    Fever and vomiting

    4100

    9.7

    91,000

    1.46

    74

    46

    2017

    22

    M

    Fever and diarrhea

    3200

    14.7

    99,000

    0.8

    73

    117

    2017

    26

    M

    Fever and diarrhea

    5400

    16.3

    127,000

    1.05

    51

    68

    AST: aspartase transaminase; ALT: Alanine transaminase; N/A: no available

    Luis Marcos, MD, MPH, Medicine, Stony Brook University, Stony Brook, NY, Kalie Smith, BS, Stony Brook University, Stony Brook, NY, Fredric Weinbaum, MD, Southampton Hospital, Southampton, NY and Eric Spitzer, MD, PhD, Stony Brook University Hospital, Stony Brook, NY

    Disclosures:

    L. Marcos, None

    K. Smith, None

    F. Weinbaum, None

    E. Spitzer, None

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