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A Day in the Woods in Pregnancy: Fetal and Neonatal Implications
J Sroda Agudogo1, Daniela Febres-Cordero1, Ai-Ris Y Collier1
1Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
Abstract:
Borrelia miyamotoi disease (BMD), also known as hard-tick relapsing fever, is an emerging tick-borne illness caused by the bacterium Borrelia miyamotoi. This pathogen is transmitted primarily by Ixodes ticks, also known as deer ticks or black-legged ticks. BMD poses significant public health concerns because of its potential to cause severe hemodynamic and hematologic disturbances, particularly in vulnerable populations such as pregnant individuals. BMD often presents with symptoms like other tick-borne infections, including fever, chills, headache, and muscle aches, but often lacks the characteristic rash seen in Lyme disease and does not typically have a greater-than-24-hour tick attachment period for transmission. A high index of suspicion in the late spring and summer months in the Northern hemisphere is essential for early diagnosis of BMD and treatment to prevent maternal and neonatal morbidity and mortality.
Insights
Borrelia miyamotoi disease (BMD) is an emerging tick-borne illness transmitted by Ixodes ticks. Early diagnosis and treatment are crucial to prevent severe complications, especially in pregnant individuals.
Area of Science:
- * Infectious Diseases
- * Microbiology
- * Public Health
Background:
- * Borrelia miyamotoi disease (BMD), or hard-tick relapsing fever, is an emerging tick-borne illness.
- * Transmitted by Ixodes ticks (deer ticks/black-legged ticks).
- * Poses public health risks, especially to pregnant individuals, due to potential severe complications.
Purpose of the Study:
- * To highlight the significance of Borrelia miyamotoi disease (BMD).
- * To emphasize diagnostic challenges and clinical presentation.
- * To stress the importance of early detection and treatment.
Main Methods:
- * Review of current literature on Borrelia miyamotoi transmission and clinical manifestations.
- * Analysis of diagnostic criteria and challenges compared to other tick-borne diseases.
- * Emphasis on epidemiological factors, including seasonal occurrence.
Main Results:
- * BMD symptoms mimic other tick-borne infections (fever, chills, headache, myalgia).
- * Characteristic rash of Lyme disease is typically absent.
- * Transmission may occur with shorter tick attachment periods than previously thought.
Conclusions:
- * A high index of suspicion is essential for timely BMD diagnosis.
- * Early diagnosis and treatment are critical to prevent maternal and neonatal morbidity and mortality.
- * Awareness is crucial during late spring and summer in the Northern Hemisphere.
