Abstract
A series of cases in the Northeast of the US during 2013–2015 described a new Borrelia species, Borrelia miyamotoi, which is transmitted by the same tick species that transmits Lyme disease and causes a relapsing fever-like illness. The geographic expansion of B. miyamotoi in the US also extends to other Lyme endemic areas such as the Midwestern US. Co-infections with other tick borne diseases (TBD) may contribute to the severity of the disease. On Long Island, NY, 3–5% of ticks are infected by B. miyamotoi, but little is known about the frequency of B. miyamotoi infections in humans in this particular region. The aim of this study was to perform a chart review in all patients diagnosed with B. miyamotoi infection in Stony Brook Medicine (SBM) system to describe the clinical and epidemiological features of B. miyamotoi infection in Suffolk County, NY. In a 5 year time period (2013–2017), a total of 28 cases were positive for either IgG EIA (n = 19) or PCR (n = 9). All 9 PCR-positive cases (median age: 67; range: 22–90 years) had clinical findings suggestive of acute or relapsing infection. All these patients were thought to have a TBD, prompting the healthcare provider to order the TBD panel which includes a B. miyamotoi PCR test. In conclusion, B. miyamotoi infection should be considered in the differential diagnosis for flu-like syndromes during the summer after a deer tick bite and to prevent labeling a case with Lyme disease.
Highlights
Suffolk County, a suburban county on Long Island (LI), New York, has a population of 1.8 million people and annually reports the highest absolute number of tickborne diseases in NY
3–5% of ticks on LI have been found to be infected by B. miyamotoi and up to 74% have B. burgdorferi [6], there is no evidence that co-infections have occurred in humans who have been diagnosed with early Lyme disease in New York [7]
B. miyamotoi PCR was ordered in these patients at Southampton Hospital (SHH) was because they had clinical manifestations compatible with a tick borne diseases (TBD) in the summer and this PCR test is part of a TBD panel offered by a commercial laboratory
Summary
Suffolk County, a suburban county on Long Island (LI), New York, has a population of 1.8 million people and annually reports the highest absolute number of tickborne diseases in NY. A series of cases in the Northeast US described a new Borrelia species, Borrelia miyamotoi, first reported to cause human infections in 2013 [2]. B. miyamotoi infection can clinically present during warm months as a flu-like syndrome similar to Lyme disease, Anaplasmosis, or Babesiosis. The diagnosis of B. miyamotoi infection is complicated by the overlap in clinical manifestations caused by other TBD and the need to order specific diagnostic tests that may not be familiar to general practitioners even in hyperendemic areas for TBD such as LI [5]. 3–5% of ticks on LI have been found to be infected by B. miyamotoi and up to 74% have B. burgdorferi [6], there is no evidence that co-infections have occurred in humans who have been diagnosed with early Lyme disease in New York [7]. The goal of this study was to describe the recent epidemiology of B. miyamotoi by performing a retrospective chart review in all patients
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