Molecular Characterization of Borrelia persica, the Agent of Tick Borne Relapsing Fever in Israel and the Palestinian Authority

Abstract

The identification of the Tick Borne Relapsing Fever (TBRF) agent in Israel and the Palestinian Authority relies on the morphology and the association of Borrelia persica with its vector Ornithodoros tholozani. Molecular based data on B. persica are very scarce as the organism is still non-cultivable. In this study, we were able to sequence three complete 16S rRNA genes, 12 partial flaB genes, 18 partial glpQ genes, 16 rrs-ileT intergenic spacers (IGS) from nine ticks and ten human blood samples originating from the West Bank and Israel. In one sample we sequenced 7231 contiguous base pairs that covered completely the region from the 5′end of the 16S rRNA gene to the 5′end of the 23S rRNA gene comprising the whole 16S rRNA (rrs), and the following genes: Ala tRNA (alaT), Ile tRNA (ileT), adenylosuccinate lyase (purB), adenylosuccinate synthetase (purA), methylpurine-DNA glycosylase (mag), hypoxanthine-guanine phosphoribosyltransferase (hpt), an hydrolase (HAD superfamily) and a 135 bp 5′ fragment of the 23S rRNA (rrlA) genes. Phylogenic sequence analysis defined all the Borrelia isolates from O. tholozani and from human TBRF cases in Israel and the West Bank as B. persica that clustered between the African and the New World TBRF species. Gene organization of the intergenic spacer between the 16S rRNA and the 23S rRNA was similar to that of other TBRF Borrelia species and different from the Lyme disease Borrelia species. Variants of B. persica were found among the different genes of the different isolates even in the same sampling area.

A case of canine borreliosis in Iran caused by Borrelia persica

“…Nos. HM13126, HM194474, HM194750-HM194752, and HM194754-HM194755) originating from either human blood samples or O. tholozani ticks from Israel and the Palestinian Authority (Safdie et al, 2010). Our IGS sequence also showed 99% similarity over 414 bp (85% coverage) with a strain from a domestic dog, and 96% over 328 bp (69% coverage) with a strain from a domestic cat (unpublished data, Acc.…”

Louse-borne relapsing fever (Borrelia recurrentis) diagnosed in 15 refugees from northeast Africa: epidemiology and preventive control measures, Bavaria, Germany, July to October 2015

“…In all cases, a preliminary diagnosis was established by clinicians based on clinical symptoms and visible spirochetes in Giemsa stained blood films The German National Reference Centre (NRC) for Borrelia in Oberschleißheim was contacted directly by clinicians for confirmation. Microbiological confirmation of LBRF from EDTA blood included: Dark field microscopy (Leitz Dialux 20 microscope, Leitz, Germany, objective 40, occular 10) and PCR targeting 16S rRNA, flab, and glpQ followed by sequencing [1][2][3].…”

Case Report: Infectious Diseases in Pilgrims Visiting the Holy Land

“…Thus preemptive diagnosis and treatment rely on clinical and laboratory findings and necessitate a high index of suspicion. In the first case the routine PCR test was aimed to detect B. persica that is endemic in Israel, 32,33 but because acquisition of infection was suspected to occur in Ethiopia, additional inquiry was done using sequencing that resulted in correct identification as B. recurrentis. In all cases the final diagnostic test results arrived after the patient had been discharged.…”

“…Blood glucose level was 100 mg/dL, creatinine 2.7 mg/dL, blood urea nitrogen (BUN) 89 mg/dL, sodium 142 mEq/L, potassium 3.9 mEq/L, alanine aminotransferase (ALT) 134 U/L, aminotransferase (AST) 491 U/L, alkaline phosphatase (AP) 361 U/L, bilirubin 4.1 mg/dL with 3.8 mg/dL direct bilirubin, and lactate dehydrogenase (LDH) 2,196 U/L. Blood coagulation tests showed an increased international normalized ratio (INR) of 1.66 and a normal partial thromboplastin time of 29 seconds (normal range [25][26][27][28][29][30][31][32][33][34][35]). An electrocardiogram (ECG) demonstrated sinus tachycardia with left bundle branch block.…”