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Published on: November 25, 2022
Human seroprevalence of Borrelia miyamotoi in Manitoba, Canada, in 2011-2014: a cross-sectional study
Kamran Kadkhoda1, Cecilia Dumouchel1, Janna Brancato1
1Affiliations: Cadham Provincial Laboratory (Kadkhoda, Gretchen); Departments of Medical Microbiology & Infectious Diseases and Immunology (Kadkhoda), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Yale School of Public Health (Dumouchel, Brancato, Krause); Yale School of Medicine (Krause), New Haven, CT.
Background:
Hard tick-borne relapsing fever caused by Borrelia miyamotoi has been reported in Russia, the Netherlands, Germany, Japan and the northeastern and upper midwestern United States. We sought to investigate the presence of B. miyamotoi infection in humans in Manitoba, Canada.
Methods:
Two hundred fifty sera collected from residents of Manitoba with suspected Lyme disease between 2011 and 2014 were tested for Borrelia burgdorferi antibody using a C6 peptide enzyme-linked immunosorbent assay (ELISA) followed by Western blot. Residual sera were then anonymized, stored at -80°C and subsequently thawed and tested for B. miyamotoi antibody using a 2-step glycerosphosphodiester phosphodiesterase-based ELISA and Western blot assay.
Results:
Twenty-four of the 250 (9.6%) sera tested positive for B. miyamotoi immunoglobulin G. Participants who were B. miyamotoi seropositive were predominantly male (54%) and younger on average than those who were seronegative (32 and 44 yr of age, respectively). Participants who were seropositive for B. burgdorferi were significantly more likely to be B. miyamotoi seropositive than those who were B. burgdorferi seronegative (20.3% v. 6.6%, respectively, odds ratio 3.6, 95% confidence interval 1.5-8.5).
Interpretation:
This initial report of human B. miyamotoi infection in Canada should raise awareness of hard tick-borne relapsing fever among clinicians and residents of areas in Canada and western North America where Lyme disease is endemic.
Insights
Hard tick-borne relapsing fever caused by Borrelia miyamotoi is now confirmed in Canada. This study found 9.6% of Manitobans with suspected Lyme disease had B. miyamotoi infection, highlighting the need for increased awareness.
Area of Science:
- Medical Entomology
- Infectious Diseases
- Public Health
Background:
- Hard tick-borne relapsing fever (HTBRF) caused by Borrelia miyamotoi (B. miyamotoi) has been documented in several countries, including parts of North America.
- Human B. miyamotoi infections have not been previously reported in Canada.
Purpose of the Study:
- To investigate the presence and seroprevalence of Borrelia miyamotoi infection in human residents of Manitoba, Canada.
- To assess the association between B. miyamotoi and Borrelia burgdorferi (Bb) seropositivity.
Main Methods:
- Sera from 250 Manitoban residents with suspected Lyme disease (2011-2014) were tested for Bb antibodies via ELISA and Western blot.
- Residual sera were tested for B. miyamotoi antibodies using a two-step glycerophosphodiester phosphodiesterase-based ELISA and Western blot assay.
Main Results:
- Of 250 sera, 9.6% (24 individuals) tested positive for B. miyamotoi immunoglobulin G (IgG).
- B. miyamotoi seropositive individuals were predominantly male and younger (average age 32) than seronegative participants (average age 44).
- Individuals seropositive for B. burgdorferi were significantly more likely to be B. miyamotoi seropositive (20.3% vs. 6.6%, OR 3.6).
Conclusions:
- This study provides the first report of human Borrelia miyamotoi infection in Canada.
- Increased clinical awareness of HTBRF is warranted in endemic areas of Canada and western North America.
- The findings suggest a potential overlap or co-infection between B. miyamotoi and B. burgdorferi in this region.
