Related Experiment Video
Updated: Apr 11, 2026
Detecting the Lyme Disease Spirochete, Borrelia Burgdorferi, in Ticks Using Nested PCR
Published on: February 4, 2018
Borrelia miyamotoi Disease in the Northeastern United States: A Case Series
Background:
The first recognized cases of Borrelia miyamotoi disease (BMD) in North America were reported in the northeastern United States in 2013.
Objective:
To further describe the clinical spectrum and laboratory findings for BMD.
Design:
Case series.
Setting:
Patients presenting to primary care offices, emergency departments, or urgent care clinics in 2013 and 2014.
Participants:
Acutely febrile patients from the northeastern United States in whom the treating health care providers suspected and ordered testing for tick-transmitted infections.
Measurements:
Whole-blood polymerase chain reaction (PCR) testing was performed for the presence of specific DNA sequences of common tickborne infections (including BMD). Serologic testing for B. miyamotoi was performed using a recombinant glycerophosphodiester phosphodiesterase (rGlpQ) protein. Clinical records were analyzed to identify the major features of acute disease.
Results:
Among 11,515 patients tested, 97 BMD cases were identified by PCR. Most of the 51 case patients on whom clinical histories were reviewed presented with high fever, chills, marked headache, and myalgia or arthralgia. Twenty-four percent were hospitalized. Elevated liver enzyme levels, neutropenia, and thrombocytopenia were common. At presentation, 16% of patients with BMD were seropositive for IgG and/or IgM antibody to B. miyamotoi rGlpQ. Most (78%) had seropositive convalescent specimens. Symptoms resolved after treatment with doxycycline, and no chronic sequelae or symptoms were observed.
Limitation:
Findings were based on specimens submitted for testing to a reference laboratory, and medical records of only 51 of the 97 case patients with BMD were reviewed.
Conclusion:
Patients with BMD presented with nonspecific symptoms, including fever, headache, chills, myalgia, and arthralgia. Laboratory confirmation of BMD was possible by PCR on blood from acutely symptomatic patients who were seronegative at presentation. Borrelia miyamotoi disease may be an emerging tickborne infection in the northeastern United States.
Primary Funding Source:
IMUGEN.
Insights
Borrelia miyamotoi disease (BMD) presents with nonspecific symptoms like fever and headache in the northeastern US. Early diagnosis via PCR and serology is key, with doxycycline effectively treating acute infections.
Area of Science:
- Infectious Diseases
- Microbiology
- Epidemiology
Background:
- Borrelia miyamotoi disease (BMD) cases were first identified in North America in the northeastern United States in 2013.
- This study aimed to further characterize the clinical presentation and laboratory findings of BMD.
Purpose of the Study:
- To describe the clinical spectrum and laboratory findings of Borrelia miyamotoi disease (BMD).
- To identify key diagnostic markers and treatment outcomes for BMD.
Main Methods:
- A case series design was employed, analyzing data from patients presenting with suspected tick-transmitted infections in the northeastern US during 2013-2014.
- Polymerase chain reaction (PCR) testing of whole blood was used to detect Borrelia miyamotoi DNA, and serologic testing with a recombinant glycerophosphodiester phosphodiesterase (rGlpQ) protein was performed.
- Clinical records of confirmed BMD cases were reviewed to document acute disease features.
Main Results:
- Out of 11,515 patients tested, 97 cases of BMD were identified by PCR.
- Common symptoms included high fever, chills, headache, myalgia, or arthralgia; 24% of patients were hospitalized.
- Elevated liver enzymes, neutropenia, and thrombocytopenia were frequent findings. Seropositivity for B. miyamotoi antibodies was low at presentation (16%) but increased in convalescent samples (78%).
Conclusions:
- Borrelia miyamotoi disease (BMD) is an emerging tickborne illness in the northeastern United States, presenting with nonspecific symptoms.
- Laboratory confirmation is achievable through PCR in acutely ill patients, even if serology is initially negative.
- Treatment with doxycycline led to symptom resolution without observed chronic sequelae.
Related Concept Videos
01:30Bacterial Phylum Spirochaetes
01:25Arboviral Encephalitis
01:28Diphtheria