It Looks Like Lyme, Acts Like Lyme, But It’s Not Lyme
Ticks responsible for transmitting Lyme disease may carry another organism that causes persistent infection in laboratory mice and prolonged, relapsing illness in humans. A study to be released in October 2011, Humans infected with relapsing fever spirochete Borrelia miyamotoi, Russia, by Platonov AE, Karan LS, Kolyasnikova NM, Makhneva NA, Toporkova MG, Maleev VV, et al. states the infection may have negative health consequences, including a relapsing disease that may last for months. There are no tests to detect the infection, and a curative treatment protocol, if one exists, has yet to be established.
In 1995 Japanese scientists proposed the name Borrelia miyamotoi for their newly discovered spirochete, strain HT31, and within a year constructed maps of the chromosome. Since that time evidence of the organism has been detected in humans, ticks, birds and wildlife in Russia, Sweden, Germany, Czechia, Poland, Canada, and in several US states (MI, NY, RI, NJ, CT, CA). Human disease caused by B. miyamotoi has recently been studied in Russia and may, according to two Yale University researchers, explain the prolonged episodes of illness designated as "chronic Lyme disease".
A Growing Concern
The Center for Wildlife at the University of Tennessee reported last year that 58% of the wild turkeys harvested by hunters from seven of its counties tested positive for exposure to the Borrelia miyamotoi spirochete during the 2009 spring and fall seasons. Additionally, 70% of turkeys studied were “infested” with juvenile Lone-star ticks (Amblyomma americanum), one of the species known to carry the bacteria that causes relapsing illness.
Experts from Fisheries and Wildlife at the University of Michigan reported at the conclusion of their five-year study (2010) that transmission of Lyme and other diseases by several tick species is occurring, and B. miyamotoi has been detected in ticks and wildlife in Michigan.
German scientists warn that unlike the Lyme disease spirochete, B. miyamotoi appears to be readily passed between generations of ticks. Researchers in CT studying the 4-Poster Deer device, licensedand promoted by the American Lyme Disease Foundation (ALDF), determined the deer bait station was not associated with changes in the prevalence of infection with microorganisms among nymphal or adult ticks, including B. miyamotoi.
According to the ALDF, one published study estimated that Lyme disease alone may cost society over two billion dollars a year, which raises concerns about the additional burden of more tick borne diseases for which there are no reliable tests and no known successful treatment protocols, including any of the 300+ known strains of Borrelia that may or may not cause human or animal disease.
A Yale University entomologist and epidemiologist were recently awarded a $300,000 NIH grant to investigate the relationship between B. miyamotoi and other Borrelia species in order to develop improved diagnostic methods and to compare the frequency and clinical symptoms of B. miyamotoi infection with those of Lyme disease. The grant recipients, once strong promoters of the no such thing as “chronic Lyme disease” theory, report B. miyamotoi “causes persistent illness with relapsing fever symptoms”; therefore, they feel information is urgently needed because it is possible that “some prolonged episodes of illness attributed to Lyme disease and designated as "chronic Lyme disease" are due to B. miyamotoi infection.”
Symptoms and Treatment
The new study by Platonov, et al. of patients with various tick borne infections included 17% who were infected with B. miyamotoi. They reported the relapsing disease is characterized by aninfluenza-like illness, headache, chills, fatigue, vomiting, myalgias, neck stiffness, and a high fever that is relatively short in duration. Study patients relapsed without treatment. Only 9% of the B. miyamotoi cases studied reported a rash. Acute B. miyamotoi infection can present more severely than the early stages of Lyme disease and it was clear that people can be infected with more than one disease after exposure to ticks.
The time from tick bite to the onset of symptoms was longer, the time from symptom onset to hospital admission was shorter, and the hospital stay was notably longer for B. miyamotoi patients. The number of symptoms reported was greater for patients with B. miyamotoi infection, and aJarisch-Herxheimer reaction was noted in 15% of the patients. When admitted to the hospital, the majority of patients were reported to have negative serology; however, some later converted to seropositive, and as with Lyme disease, some did not seroconvert.
The study’s treatment protocol consisted of a trial of either 2 weeks of IV ceftriaxone (42 patients), or 2 weeks of oral Doxycycline (2 patients). There is no test to determine a cure. The time between relapses in B. miyamotoi infected patients averaged 9 days (range 2 days to 2 weeks), however, researchers felt early treatment may have prevented subsequent relapses for the majority of patients.
Researchers noted B. miyamotoi infection may cause substantial health problems given its relatively high incidence and its associated severity. Relapsing febrile episodes were only reported for B. miyamotoi patients as compared to patients with other tick borne illnesses. Such multiple disease episodes not only have an adverse effect on a patient’s health, but also may result in costly medical bills, many days or weeks of lost wages, and a medical misdiagnosis. Co-infection of B. miyamotoiwith other ixodid tick–transmitted agents may increase disease severity. Additional problems that might occur with B. miyamotoi infection are ocular, neurologic, respiratory, cardiac, and pregnancy complications associated with relapsing fever, similar to what is found in Lyme disease patients.
Concern was expressed by study authors that patients may remain undiagnosed because of the nonspecific nature of the illness, which might be confused with viral infections or such tick-borne infections as Lyme disease, babesiosis, anaplasmosis, or ehrlichiosis- and because of the lack of laboratory tests for confirmatory diagnosis.
1996 Hiroshima Japan