Review
Version 1
Preserved in Portico This version is not peer-reviewed
Relapsing Review: A Research Update on Borrelia miyamotoi
Version 1
: Received: 26 December 2022 / Approved: 30 December 2022 / Online: 30 December 2022 (08:08:13 CET)
A peer-reviewed article of this Preprint also exists.
Cleveland, D.W.; Anderson, C.C.; Brissette, C.A. Borrelia miyamotoi: A Comprehensive Review. Pathogens 2023, 12, 267. Cleveland, D.W.; Anderson, C.C.; Brissette, C.A. Borrelia miyamotoi: A Comprehensive Review. Pathogens 2023, 12, 267.
Abstract
Borrelia miyamotoi is an emerging tick-borne pathogen in the Northern hemisphere and is the causative agent of Borrelia miyamotoi disease (BMD). B. miyamotoi is vectored by the same hard-bodied ticks as Lyme disease Borrelia, yet phylogenetically groups with relapsing fever Borrelia, and thus has been uniquely labeled a hard tick-borne relapsing fever Borrelia. Burgeoning research has uncovered new aspects of B. miyamotoi in human patients, nature, and the lab. Of particular interest are novel findings on disease pathology, prevalence, diagnostic methods, ecological maintenance, transmission, and genetic characteristics. Herein we review recent literature on B. miyamotoi, discuss how findings adapt to current Borrelia doctrines, and briefly consider what remains unknown about B. miyamotoi.
Keywords
Borrelia miyamotoi, Ixodes, Lyme disease, relapsing fever, reservoir species, tick-borne disease, vector
Subject
Biology and Life Sciences, Immunology and Microbiology
Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Commenter: Wendy Adams
The commenter has declared there is no conflict of interests.
Great paper, I have enjoyed reading it and learned a few nuggets.
A few things - first, table 1 for US is missing ixodes pacificus.
Second, under 3. Disease: you leave the impression this is a mild disease, but in Molloy et al (your ref 39), a case series of 51 patients with confirmed BMD, 24% were hospitalized and 51% were thought to be septic.
From the paper:
Clinical Spectrum of BMD
Basic clinical data were available for 51 case patients with definitive BMD selected out of 97 total. The clinical spectrum of disease was variable, but presenting
symptoms were often suggestive of an undifferentiated flu-like illness. Patients presented with acute headache, fever, and chills and were often found to
have leukopenia, thrombocytopenia, and elevated aminotransferase levels, mimicking human anaplasmosis infection (Tables 1 and 2). Patients were commonly described
as appearing “toxic”; more than 50% were suspected of having sepsis, and 24% required hospitalization. The headaches were most commonly described
as severe, resulting in head computed tomography scans and spinal taps in 5 patients. Two patients presented with recurrent fever, and 1 of them, who was not
treated initially, yielded blood samples drawn a month apart that were positive on PCR.
Would you consider rethinking the Disease section and adding a reference to that case series? The hospitalization rate and septic appearence of the patients would be important to relay as that is very different than other TBD and could be a clue to physicians who are evaluating the patient for different TBD.
This high rate could be due to "immunosuppression" (but doubtfully for all patients), and that doesn't seem to be addressed in the Molloy paper. Anecdotally I heard Sam Telford present one of the cases - the patient was found slumped over in a parked car. that doesn't happen in most other TBD.
TIA,
Wendy