When to Think About Other Borreliae:: Hard Tick Relapsing Fever (Borrelia miyamotoi), Borrelia mayonii, and Beyond

Area of Science:

• Medical Entomology
• Infectious Diseases
• Bacteriology

Background:

• Hard ticks transmit various Borrelia species causing human disease in North America.
• Borrelia burgdorferi is the most common cause, but other species like Borrelia miyamotoi, Borrelia mayonii, and Borrelia bissettii are emerging pathogens.
• Overlapping clinical presentations and non-specific diagnostic tools contribute to under-reporting of these infections.

Purpose of the Study:

• To review the epidemiology, clinical manifestations, diagnosis, and treatment of lesser-known Borrelia species causing human disease in North America.
• To highlight the challenges in diagnosing and managing infections by these pathogens.
• To improve awareness and reporting of these tick-borne diseases.

Main Methods:

• Literature review of epidemiological data.
• Analysis of clinical case reports and studies.
• Summary of current diagnostic and treatment guidelines.

Main Results:

• Several Borrelia species, including B. miyamotoi, B. mayonii, and B. bissettii, are confirmed North American tick-borne pathogens.
• Clinical syndromes often mimic Lyme disease, complicating diagnosis.
• Accurate diagnostic methods and targeted treatment are crucial for effective management.

Conclusions:

• Infections with less common Borrelia species are an under-recognized public health concern in North America.
• Enhanced diagnostic strategies and clinician awareness are needed to improve case detection.
• Prompt and appropriate treatment is essential to prevent severe outcomes from these tick-borne illnesses.