Borrelia Miyamotoi Infection - Symptoms, Diagnosis, Treatment, and Prevention

Introduction:

Borrelia miyamotoi is a bacteria recently identified to cause human diseases. It was discovered in Japan in 1995. However, the first human infection was reported in Russia in 2011 and in 2013 in the United States. It is currently an emerging infection in Connecticut and the United States and appears similar to Lymes disease. It occurs mainly in the world's northern hemisphere and is often seen along with Borrelia burgdorferi, which causes Lymes disease.

What Is Borrelia Miyamotoi?

Borrelia miyamotoi is a bacteria transmitted by tiny, infected deer ticks. The nymphs are most active during the warm weather season between May and July. Adult ticks are more active during fall and spring but could also be searching for a host at any time except in freezing winters. Until recent times, the Borrelia miyamotoi was believed to occur only in three geographical areas: Asia, Europe, and America; however, more diversity of the organism species is now being recognized.

How Is Borrelia Miyamotoi Infection Spread?

Borrelia miyamotoi, also known as hard tick relapsing fever, is spread to humans through tick vectors, especially black-legged or deer ticks (Ixodes scapularis) and western black-legged ticks (Ixodes pacificus). These ticks would have acquired the pathogen directly from a vertebrate reservoir host or transmitted it from the female tick to its offspring. Ixodes scapularis also transmit Lymes disease, babesiosis, anaplasmosis, and Powassan virus.

Who Is At Risk Of Borrelia Miyamotoi Infections?

• People engaging in outdoor activities like hiking, camping, and gardening could increase the risk of a tick bite.

• Furry pets could be carriers of ticks into the house.

• People staying in wooded and bushy areas surrounded by tall grass are at higher risk of tick bites.

What Are The Symptoms Of Borrelia Miyamotoi Infection?

The signs and symptoms may occur within days to weeks of the bite and include:

• Fever.

• Fatigue.

• Chills.

• Severe headache.

• Arthralgia (joint pain).

• Myalgia (muscle pain).

• Dizziness.

• Confusion.

• Vertigo (sensation of moving or spinning).

• Nausea.

• Dyspnea.

• Abdominal pain.

• Diarrhea.

• Anorexia (loss of appetite).

• Bull’s eye rashes.

How To Diagnose Borrelia Miyamotoi Infection?

Diagnosis of Borrelia miyamotoi infection relies on the signs and symptoms of the patient, along with a few laboratory tests:

• Polymerase chain reaction or PCR test helps detect the organism's DNA (deoxyribonucleic acid).

• Antibody-based tests.

• C6 peptide ELISA (enzyme-linked immunosorbent assay) test.

How Is Borrelia Miyamotoi Infection Treated?

A defined treatment regimen for Borrelia miyamotoi infection has not been identified to date. Instead, the treatment for Lymes disease is effective in most patients with Borrelia miyamotoi infection. The treatment includes a 10 to 14 days course of antibiotics orally. Antibiotics like Doxycycline, Amoxicillin, and Cefuroxime Axetil are used in adults and children, whereas Cefuroxime and Amoxicillin are used in breastfeeding people.

What Are The Other Diseases That May Present Similar To Borrelia Miyamotoi Infection?

• Lyme Disease: Lymes disease is caused by Borrelia burgdorferi; the vectors are Ixodes species of ticks. Some common symptoms of Lymes disease include a bull’s eye rash, weakness in the legs, sleep disturbances, swollen lymph nodes, joint pain, etc.

• Tick-Borne Relapsing Fever: It is caused by the Borrelia species of bacteria, and the vectors are Ornithodoros moubata or African tick.

• Anaplasmosis: It is caused by the Anaplasma phagocytophilum bacteria; the vectors are Ixodes species of ticks.

• Powassan: It is caused by the Powassan virus; the vectors are Ixodes species and Dermacentor andersoni.

• Babesiosis: It is caused by the protozoan Babesia; the vectors are Ixodes species of ticks.

How To Prevent Borrelia Miyamotoi Infection?

One may prevent the disease by simply preventing tick bites.

• Avoid areas that may be prone to ticks.

• Wear long-sleeved clothes and use protective gear like gloves when walking through bushy areas.

• Use tick repellants or EPA (environmental protection agency)-registered insect repellents or insect repellents containing picaridin, DEET (N, N-Diethyl-meta-toluamide),

• Oil of lemon eucalyptus, or para-methane-diol when going in the wild.

• Wash clothes thoroughly with hot water and 0.5 percent Permethrin.

• Take a body shower immediately after coming from outside or within two hours.

• Check the body closely for ticks every day, especially in tick-prone areas like the armpit, behind the knees, scalp, etc.

• Get pet dogs and cats checked regularly for ticks and use products recommended by a veterinarian to prevent ticks on them.

• Cut down tall grass and bushes from front yards and lawns.

• Walk on the central trail when walking on grassy areas.

• Maintain a three feet-wide barrier of gravel between the lawn and wooded areas to prevent tick migration.

• Keep wood stacked neatly in a dry place.

• Remove any old mattresses or furniture from the yard that may become hides for ticks.

• Apply pesticides like acaricides to reduce the number of ticks. Consult a professional company and the local health official to apply pesticides at home.

What To Do After A Tick Bite?

• Remove The Tick Cautiously: The immediate step after noticing a tick stuck to the body is to remove it. First, gently grasp the tick close to the skin using a tweezer. Then, pull the tick upwards without twisting or jerking with steady and even pressure.

• Clean The Bite Area: Clean the bite area immediately after removing the tick with soap and water or rubbing alcohol.

• Storage Of The Tick: Either flush the tick down the toilet or store it in a tightly sealed container with rubbing alcohol to take it to the healthcare provider later. Do not crush the tick as it may contain pathogens, which can get released into the environment.

• Watch For Any Symptoms For 30 Days: If symptoms like fever, breathlessness, fatigue, rash, muscle pain, or joint pain occur, a healthcare provider must be contacted immediately. Further treatment would be symptom-based antibiotics.

Conclusion:

Borrelia miyamotoi infection has been around for a long time but was recently identified to cause diseases in humans. It is spread to humans through hard tick bites, especially Ixodes scapularis. The condition is treated similar to Lymes disease with antibiotics as there has been no recognized regimen specific to Borrelia miyamotoi infection. Therefore, avoiding tick bites is the only way to prevent the disease.