Borrelia miyamotoi Disease Information for Health Professionals

Borrelia miyamotoi disease is a bacterial illness most likely transmitted to humans by the blacklegged (deer) tick. The disease agent is closely related to the bacteria that cause tickborne relapsing fever and distantly related to the bacteria that causes Lyme disease. Human illness due to B. miyamotoi was first identified in 2011 with the first case in Minnesota reported in 2016. Since then, a low number of cases have been reported in Minnesota residents each year.

On this page:
Clinical presentation
Diagnostic tests
Treatment
Guidelines
Reporting

Clinical Presentation

While the spectrum of illness due to B. miyamotoi is still being described, common signs and symptoms that have been reported to date include fever, headache, myalgia, and fatigue. Some patients with illness due to B. miyamotoi have also described recurring symptoms prior to diagnosis and treatment. Severe illness, such as meningoencephalitis, have also been reported.

Diagnostic tests

Currently, confirmation of a diagnosis relies on the use of polymerase chain reaction (PCR) tests that detect DNA from the organism or antibody-based tests. Further research is needed to better understand how frequently cross-reactivity with similar Borrelia species may occur with serologic testing for B. miyamotoi. Serologic and PCR tests are under development and not widely available but can be ordered from a limited number of CLIA-approved laboratories.

Treatment

Patients diagnosed with infection due to B. miyamotoi have been successfully treated with a 2-4 week course of doxycycline. Amoxicillin and ceftriaxone have also been used.

Guidelines

• CDC: Borrelia miyamotoi
  
  
• CDC: Tickborne Diseases of the United States: A Reference Manual for Health Care Providers
  CDC Handbook, designed as a way for health care providers to access information on tickborne diseases and tick identification. 
  
  
• IDSA: The Clinical Assessment, Treatment, and Prevention of Lyme Disease, Human Granulocytic Anaplasmosis, and Babesiosis
  Clinical Practice Guidelines by the Infectious Diseases Society of America.

Reporting

• Reporting Lyme Disease
  Minnesota Rules Governing Communicable Diseases require Lyme Disease (Borrelia burgdorferi, and other Borrelia spp.) to be reported to MDH within one working day.
  
  MDH staff also are available to provide clinical consultation regarding diagnosis and treatment of B. miyamotoi and other tick-borne diseases. Call 651-201-5414 for a clinical consultation.