High seroprevalence of Borrelia miyamotoi antibodies in forestry workers and individuals suspected of human granulocytic anaplasmosis in the Netherlands

Abstract

Substantial exposure to Borrelia miyamotoi occurs through bites from Ixodes ricinus ticks in the Netherlands, which also transmit Borrelia burgdorferi sensu lato and Anaplasma phagocytophilum. Direct evidence for B. miyamotoi infection in European populations is scarce. A flu-like illness with high fever, resembling human granulocytic anaplasmosis, has been attributed to B. miyamotoi infections in relatively small groups. Borrelia miyamotoi infections associated with chronic meningoencephalitis have also been described in case reports. Assuming that an IgG antibody response against B. miyamotoi antigens reflects (endured) infection, the seroprevalence in different risk groups was examined. Sera from nine out of ten confirmed B. miyamotoi infections from Russia were found to be positive with the recombinant antigen used, and no significant cross-reactivity was observed in secondary syphilis patients. The seroprevalence in blood donors was set at 2.0% (95% CI 0.4–5.7%). Elevated seroprevalences in individuals with serologically confirmed, 7.4% (2.0–17.9%), or unconfirmed, 8.6% (1.8–23%), Lyme neuroborreliosis were not significantly different from those in blood donors. The prevalence of anti-B. miyamotoi antibodies among forestry workers was 10% (5.3–16.8%) and in patients with serologically unconfirmed but suspected human granulocytic anaplasmosis was 14.6% (9.0–21.8%); these were significantly higher compared with the seroprevalence in blood donors. Our findings indicate that infections with B. miyamotoi occur in tick-exposed individuals in the Netherlands. In addition, B. miyamotoi infections should be considered in patients reporting tick bites and febrile illness with unresolved aetiology in the Netherlands, and other countries where I. ricinus ticks are endemic.

Borrelia miyamotoi: a widespread tick-borne relapsing fever spirochete

“…Of note, 11% of B. miyamotoi seropositive sera were also positive for B. burgdorferi [80,81]. These findings were confirmed by a GlpQ-Luminex based study in the Netherlands, where a high seroprevalence to B. miyamotoi was found in forestry workers (10%) and patients with Lyme neuroborreliosis (7.4%) compared with 2% in blood donors [82]. Prospective studies should be performed to assess how often B. miyamotoi seropositivity in patients with Lyme borreliosis derives from co-infections, crossreactivity, or previously experienced infections.…”

“…In the Dutch study, 130 serum samples that had been initially analyzed for human granulocytic anaplasmosis (HGA) serology, but turned out to be negative, were analyzed for B. miyamotoi antibodies. Interestingly, 19 of these patients (14.6%) were found to be seropositive for B. miyamotoi, suggesting that B. miyamotoi is a common cause of HGA-like disease [82].…”

Borrelia miyamotoi infection in nature and in humans

“…Although the novelty and wide geographic distribution of B. miyamotoi have been recognized for several years now, this spirochete received comparatively little attention until human cases of a relapsing fever-like disease from B. miyamotoi infection were reported in 2011 in Russia, and subsequently in the United States, Europe, and Japan [10,32–38]. These reports have documented the public health importance of B. miyamotoi .…”

“…These reports have documented the public health importance of B. miyamotoi . Human B. miyamotoi infection appears to be comparable in frequency to babesiosis or human granulocytic anaplasmosis (HGA) in the northeastern U.S. and may cause severe disease, including meningoencephalitis in immunocompromised individuals, as well as coinfection with other Ixodes -borne pathogens [10,32–38]. Additionally, antigenic cross-reactivities in immunoassays between Borrelia species in North America may complicate diagnosis of both Lyme disease and relapsing fever [39].…”

Borrelia miyamotoi: egy újabb, humán patogén, kullancs által terjesztett, visszatérő lázat okozó baktérium

“…Csaknem lehetetlen feladat biztosan negatív és biztosan pozitív eseteket találni. Egy holland vizsgálat szerint 150 véradó 2%-a volt szeropozitív [41]. Ez egyben azt jelenti, hogy a vizsgálat specificitása 98%, ami nagyszerűnek tűnik.…”