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First US Cases of Borrelia Miyamotoi Identified

durland fish lyme disease researcher

Durland Fish, PhD, who first identified B.miyamotoi in the US.

Peter Krause, MD., and a number of other prominent Lyme disease researchers have published details of the first identified cases of Borrelia miyamotoi infection in US patients. Antibodies to the bacteria, which belongs to the same genus as Lyme disease bacteria, have been found in 18 patients in a recent study, with 3 patients appearing to be suffering from symptoms of the infection. This discovery offers a possible explanation for those apparently suffering from Lyme disease but who repeatedly test seronegative using ELISA and Western Blot as B. miyamotoi is not (yet) one the strains of bacteria included in such tests.

What is B. miyamotoi?

Borrelia burgdorferi is the predominant cause of Lyme disease in the US, with a number of ticks acting as vectors for the infection. B. miyamotoi is genetically similar to B. burgdorferi and has been detected in all of the ticks that are vectors for Lyme disease, including Ixodes scapularis. The presence of such bacteria is not new, but this is the first incidence of reported cases of human infection in the US. Ticks in Connecticut were found to be carrying B. miyamotoi back in 2001, with Russian cases of human infection with bacteria reported in 2011.

Diagnosing B. miyamotoi Infection

The study looked at three groups of patients living in Block Island and Prudence Island, Rhode Island, and Brimfield, Massachusetts between 1990 and 2010. Samples from these patients were tested using ELISA and Western Blot for antibodies to GlpQ protein, specific to B. miyamotoi and not reactive for B. burgdorferi. The bacteria was found to be present in 3.2% of cases of suspected Lyme disease in patients from southern New England, and B. miyamotoi was found in 21% of cases of patients presenting with a viral-like illness at a clinic in southern New York. Three patients were found to have antibody levels at least four times as high as those in convalescent samples, suggesting a recent infection with the bacteria. The patients found to be infected with B. miyamotoi were treated with doxycycline or amoxicillin.

Updating Lyme Disease Tests

These results suggest that inclusion of B. miyamotoi in the two-tier testing for Lyme disease is warranted, just as it is now included in testing panels in Russia, and in parts of Europe. Unlike the Russian cases, however, none of the patients in this study had compromised immune systems, also highlighting a need to consider the diagnosis of B. miyamotoi infection where symptoms of Lyme disease are present in otherwise healthy individuals.


Peter J. Krause, P.J., Narasimhan, S., Wormser, G.P., Rollend, L., Fikrig, E., Lepore, T., Barbour, A., Fish, D., Human Borrelia miyamotoi Infection in the United States, N Engl J Med 2013; 368:291-293.

{ 3 comments… add one }
  • Lisa July 7, 2013, 1:05 pm

    This sure would help me i bet get the diagnosis i need to treat. I was bit by a lone star tick nine years ago, i am treated by clinical symptoms but a true diagnosis that the insurance companies would have to accept would be a dream to me.

  • nancy jones August 3, 2013, 9:29 am

    O.K. Ive been reading alot about the tick sicknesses we were not allowed to have not long ago. Now it is big enough there is no place to hide the fact IT”S REAL. I read that a few years ago there was a vacine, however, it was set aside due to its low per percentage of success. I’m a firm believer that any chance is better than no chance at being able to protect some people from this very real and very serious diease!

  • Tom October 31, 2013, 9:56 pm

    Its common knowledge that many people suspected of Lyme test negative on the standard CDC 2 tiered test for b31 B burgorferi. They are rarely treated. The test was developed in 1995 before other species were found in the US. Its now known that B miyamotoi is found in a high percentage of ticks in the Northeast and by Kerry Padget at the California Department of Health in CA. Now they know its pathogenic in both Russia and the Northeast. There is no test available that will catch B miyomotoi or B bissettii, also found in CA. There seems no interest in developing a commercially available test either based on the Western blot using B miyamotoi antigens or a GlpQ protein ELISA. Imugen has the GlpQ ELISA but refuses to do testing. They do however offer a GlpQ PCR that is about 1-5% sensitive which is useless. And the medical community wonders why people are upset when its obvious many people are going undiagnosed due to new strains and species proven to be pathogenic and known to be missed by standard testing. Its also known the European Euroline with VlsE is able to catch these species. Its been used and tested for years. It cannot be sold in the US since its not FDA approved and the kit suppliers have no incentive to get FDA approval. So tests are available yet the CDC and medical community just sweep it under the rug. Shameful.

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