Frequency and Geographic Distribution of Borrelia miyamotoi, Borrelia burgdorferi, and Babesia microti Infections in New England Residents

Demerise Johnston, Yale School of Public Health, Department of Epidemiology of Microbial Diseases and Yale School of Medicine, New Haven, Connecticut, USA.
Jill R. Kelly, Yale School of Public Health, Department of Epidemiology of Microbial Diseases and Yale School of Medicine, New Haven, Connecticut, USA.
Michel Ledizet, L2 Diagnostics, New Haven, Connecticut, USA.
Nathalie Lavoie, L2 Diagnostics, New Haven, Connecticut, USA.
Robert P. Smith, Maine Medical Center, Portland, Maine, USA.
Jeffrey Parsonnet, Mary Hitchcock Hospital, Hanover, New Hampshire, USA.
Jonathan Schwab, Northampton Area Pediatrics, Northampton, Massachusetts, USA.
John Stratidis, Danbury Hospital, Danbury, Connecticut, USA.
Scott Espich, Yale School of Public Health, Department of Epidemiology of Microbial Diseases and Yale School of Medicine, New Haven, Connecticut, USA.
Giyoung Lee, Yale School of Public Health, Department of Epidemiology of Microbial Diseases and Yale School of Medicine, New Haven, Connecticut, USA.
Kaitlin R. Maciejewski, Yale School of Public Health, Department of Epidemiology of Microbial Diseases and Yale School of Medicine, New Haven, Connecticut, USA.
Yanhong Deng, Yale School of Public Health, Department of Epidemiology of Microbial Diseases and Yale School of Medicine, New Haven, Connecticut, USA.
Victoria Majam, US Food and Drug Administration, Laboratory of Emerging Pathogens, Silver Spring, Maryland, USA.
Hong Zheng, US Food and Drug Administration, Laboratory of Emerging Pathogens, Silver Spring, Maryland, USA.
Sougr-Nooma Bonkoungou, US Food and Drug Administration, Laboratory of Emerging Pathogens, Silver Spring, Maryland, USA.
June Stevens, Yale New Haven Hospital, Department of Laboratory Medicine, New Haven, Connecticut, USA.
Sanjai Kumar, US Food and Drug Administration, Laboratory of Emerging Pathogens, Silver Spring, Maryland, USA.
Peter J. Krause, Yale School of Public Health, Department of Epidemiology of Microbial Diseases and Yale School of Medicine, New Haven, Connecticut, USA.

Document Type

Article

Publication Date

3-23-2022

Journal Title

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

Abstract

BACKGROUND: Borrelia miyamotoi is a relapsing fever spirochete that relatively recently has been reported to infect humans. It causes an acute undifferentiated febrile illness that can include meningoencephalitis and relapsing fever. Like Borrelia burgdorferi, it is transmitted by Ixodes scapularis ticks in the northeastern United States and by Ixodes pacificus ticks in the western United States. Despite reports of clinical cases from North America, Europe, and Asia, the prevalence, geographic range, and pattern of expansion of human B. miyamotoi infection are uncertain. To better understand these characteristics of B. miyamotoi in relation to other tickborne infections, we carried out a cross-sectional seroprevalence study across New England that surveyed B. miyamotoi, B. burgdorferi, and Babesia microti infections. METHODS: We measured specific antibodies against B. miyamotoi, B. burgdorferi, and B. microti among individuals living in 5 New England states in 2018. RESULTS: Analysis of 1153 serum samples collected at 11 catchment sites showed that the average seroprevalence for B. miyamotoi was 2.8% (range, 0.6%-5.2%), which was less than that of B. burgdorferi (11.0%; range, 6.8%-15.6%) and B. microti (10.0%; range, 6.5%-13.6%). Antibody screening within county residence in New England showed varying levels of seroprevalence for these pathogens but did not reveal a vectoral geographical pattern of distribution. CONCLUSIONS: Human infections caused by B. miyamotoi, B. burgdorferi, and B. microti are widespread with varying prevalence throughout New England.

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