Lyme Disease: Diversity of Borrelia Species in California and Mexico Detected Using a Novel Immunoblot Assay

Abstract

Background: With more than 300,000 new cases reported each year in the United States of America (USA), Lyme disease is a major public health concern. Borrelia burgdorferi sensu stricto (Bbss) is considered the primary agent of Lyme disease in North America. However, multiple genetically diverse Borrelia species encompassing the Borrelia burgdorferi sensu lato (Bbsl) complex and the Relapsing Fever Borrelia (RFB) group are capable of causing tickborne disease. We report preliminary results of a serological survey of previously undetected species of Bbsl and RFB in California and Mexico using a novel immunoblot technique. Methods: Serum samples were tested for seroreactivity to specific species of Bbsl and RFB using an immunoblot method based on recombinant Borrelia membrane proteins, as previously described. A sample was recorded as seropositive if it showed immunoglobulin M (IgM) and/or IgG reactivity with at least two proteins from a specific Borrelia species. Results: The patient cohort consisted of 90 patients residing in California or Mexico who met the clinical case definition of chronic Lyme disease. Immunoblot testing revealed that 42 patients were seropositive for Bbsl (Group 1), while 56 patients were seropositive for RFB (Group 2). Eight patients were seropositive for both Bbsl and RFB species. Group 1 included patients who were seropositive for Bbss (14), B. californiensis (eight), B. spielmanii (10), B. afzelii/B. garinii (10), and mixed infections that included B. mayonii (three). Group 2 included patients who were seropositive for B. hermsii (nine), B. miyamotoi (seven), B. turicatae (nine), and B. turcica (two). In the remaining Group 1 and Group 2 patients, the exact Borrelia species could not be identified using the immunoblot technique. Conclusions: Lyme disease is associated with a diverse group of Borrelia species in California and Mexico. Current testing for Lyme disease focuses on detection of Bbss, possibly resulting in missed diagnoses and failure to administer appropriate antibiotic therapy in a timely manner. The genetic diversity of Borrelia spirochetes must be considered in future Lyme disease test development.

Presentation of Acrodermatitis Chronica Atrophicans Rashes on Lyme Disease Patients in Canada

“…Consistent with syphilis [ 99 ], Lyme disease may be an insidious neurologic pathogenesis characterized with demyelination and, ultimately, can be a fatal spirochetosis [ 74 , 78 , 88 , 90 ]. Late stage chronic Lyme disease has been defined [ 3 , 86 , 90 , 100 , 101 ], and persistent infection with or without administration of antibiotics is clearly a feature with this tick-borne, zoonotic disease [ 90 ]. Furthermore, this stealth pathogen is pleomorphic with diverse forms that include spirochetes, spherocytes (round bodies), blebs, granules and, collectively, biofilms exacerbate the sequestration of Bbsl infection.…”

“…Several of these Bbsl genospecies are known to be pathogenic to humans. In continental North America, at least eight Bbsl genospecies have pathogenic potential, including B. afzelii [ 2 , 3 ], B. bissettiae [ 4 , 5 , 6 , 7 , 8 , 9 , 10 ], B. burgdorferi sensu stricto [ 1 , 3 , 11 ], B. californiensis [ 3 , 6 ], B. garinii [ 3 , 11 , 12 ], B. kurtenbachii [ 13 , 14 , 15 ], B. mayonii [ 16 ], and B. spielmanii [ 3 , 17 , 18 ]. European countries have three other Bbsl genospecies that are determined to be pathogenic to humans, namely B. bavariensis [ 19 , 20 ], B. lusitaniae [ 21 , 22 ], and B. valaisiana [ 23 , 24 ].…”

“…An erythema migrans (EM) rash can last 2 years while an ACA rash can last 10 years or more [ 36 ]. Epidemiologically, B. afzelii has recently been detected in North American patients [ 3 ].…”

<p>Classification and Staging of Morgellons Disease: Lessons from Syphilis</p>

“…59 Our understanding of Bbsl infection is in its infancy, however, and some species classified as non-pathogenic may yet be shown to cause human disease. 60 Our knowledge of RFB is even more limited in scope than our knowledge of Bbsl. In the USA, there is no case definition for relapsing fever (RF) and it is not nationally reportable.…”

Detection of Borrelia burgdorferi Sensu Lato and Relapsing Fever Borrelia in Feeding Ixodes Ticks and Rodents in Sarawak, Malaysia: New Geographical Records of Borrelia yangtzensis and Borrelia miyamotoi

“…High incidences of LD and high occurrences of its causative bacterium have been continuously reported since the discovery of LD spirochetes in 1982 in North America and later in 1983 in Europe [ 4 ]. In North America, several Bbsl genospecies, including B. burgdorferi sensu stricto (Bbss), B. afzelii , B. garinii , B. californiensis , B. bissettiae , B. kurtenbachii , B. mayonii , and B. spielmanii are known to be responsible for LD [ 5 , 6 , 7 , 8 , 9 ]. While in Europe, Bbss, B. garinii , B. afzelii , and B. bavariensis are the predominant causative bacterium for LD cases [ 10 ].…”