Novel U.S.A. pathogenic B. burgdorferi sensu lato species - Borrelia Mayonii

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dlf
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Novel U.S.A. pathogenic B. burgdorferi sensu lato species - Borrelia Mayonii

Post by dlf » Sun 7 Feb 2016 3:16

http://www.thelancet.com/journals/lanin ... 8/abstract

Identification of a novel pathogenic Borrelia species causing Lyme borreliosis with unusually high spirochaetaemia: a descriptive study

Bobbi S Pritt, MD, Paul S Mead, MD, Diep K Hoang Johnson, BS, David F Neitzel, MS, Laurel B Respicio-Kingry, MS, Prof Jeffrey P Davis, MD, Elizabeth Schiffman, MPH, Lynne M Sloan, MT, Martin E Schriefer, PhD, Adam J Replogle, BS, Prof Susan M Paskewitz, PhD, Julie A Ray, MPH, Jenna Bjork, DVM, Christopher R Steward, MPH, Alecia Deedon, BS, Xia Lee, MS, Luke C Kingry, PhD, Tracy K Miller, PhD, Michelle A Feist, BS, Elitza S Theel, PhD, Prof Robin Patel, MD, Cole L Irish, BS, Jeannine M Petersen, PhD

Published Online: 05 February 2016
Summary
Background
Lyme borreliosis is the most common tick-borne disease in the northern hemisphere. It is a multisystem disease caused by Borrelia burgdorferi sensu lato genospecies and characterised by tissue localisation and low spirochaetaemia. In this study we aimed to describe a novel Borrelia species causing Lyme borreliosis in the USA.

Methods
At the Mayo clinic, from 2003 to 2014, we tested routine clinical diagnostic specimens from patients in the USA with PCR targeting the oppA1 gene of B burgdorferi sensu lato. We identified positive specimens with an atypical PCR result (melting temperature outside of the expected range) by sequencing, microscopy, or culture. We collected Ixodes scapularis ticks from regions of suspected patient tick exposure and tested them by oppA1 PCR.

Findings
100 545 specimens were submitted by physicians for routine PCR from Jan 1, 2003 to Sept 30, 2014. From these samples, six clinical specimens (five blood, one synovial fluid) yielded an atypical oppA1 PCR product, but no atypical results were detected before 2012. Five of the six patients with atypical PCR results had presented with fever, four had diffuse or focal rash, three had symptoms suggestive of neurological inclusion, and two were admitted to hospital. The sixth patient presented with knee pain and swelling. Motile spirochaetes were seen in blood samples from one patient and cultured from blood samples from two patients. Among the five blood specimens, the median oppA1 copy number was 180 times higher than that in 13 specimens that tested positive for B burgdorferi sensu stricto during the same time period. Multigene sequencing identified the spirochaete as a novel B burgdorferi sensu lato genospecies. This same genospecies was detected in ticks collected at a probable patient exposure site.

Interpretation
We describe a new pathogenic Borrelia burgdorferi sensu lato genospecies (candidatus Borrelia mayonii) in the upper midwestern USA, which causes Lyme borreliosis with unusually high spirochaetaemia. Clinicians should be aware of this new B burgdorferi sensu lato genospecies, its distinct clinical features, and the usefulness of oppA1 PCR for diagnosis.

Funding
US Centers for Disease Control and Prevention Epidemiology and Laboratory Capacity for Infectious Diseases (ELC) Cooperative Agreement and Mayo Clinic Small Grant programme.

NOTE: Access to full text requires paid subscription or payment for article.

dlf
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Re: Novel U.S.A. pathogenic B. burgdorferi sensu lato species - Borrelia Mayonii

Post by dlf » Sun 7 Feb 2016 14:14

In addition to the abstract, the Mayo clinic has issued a news article and a short video interview. They have noted in this article that according to the clinical information they have for the six patients studied, that standard two-tier testing will identify patients with this novel Borrelia species. I wondered about that, since the abstract did not mention antibody reactivity. With such a small patient cohort, I am still wondering whether patients infected solely with B. mayonii do reliably test positive, or whether these patients were only recognized because they were two-tier positive, possibly as a result of also being co-infected with a B. burgdorferi strain that is reactive in standard testing. Maybe there will be more information about this in the full text version.

http://newsnetwork.mayoclinic.org/discu ... e-disease/

Mayo Researchers Identify New Borrelia Species that Causes Lyme Disease
By apriljosselyn
Friday, February 5, 2016

lou
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Re: Novel U.S.A. pathogenic B. burgdorferi sensu lato species - Borrelia Mayonii

Post by lou » Wed 10 Feb 2016 2:35

Why is Mayo doing PCR instead of two tier testing? Didn't the CDC tell us PCR not a good lyme test because of contamination? Maybe they pick and choose which labs they describe as contaminated. Too many positives....got to be contamination.

dlf
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Re: Novel U.S.A. pathogenic B. burgdorferi sensu lato species - Borrelia Mayonii

Post by dlf » Fri 12 Feb 2016 16:44

In addition to the material posted above there is also an audio interview with Dr. Bobbi Pritt available from the Lancet:

Lyme disease: The Lancet Infectious Diseases : February 5, 2016
Dr. Bobbi Pritt discusses a newly discovered genospecies of Lyme borreliosis.

Available from:

http://www.thelancet.com/pb/assets/raw/ ... bruary.mp3

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ta2Ed
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Re: Novel U.S.A. pathogenic B. burgdorferi sensu lato species - Borrelia Mayonii

Post by ta2Ed » Sun 14 Feb 2016 11:20

Vale.

Lorima
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Re: Novel U.S.A. pathogenic B. burgdorferi sensu lato species - Borrelia Mayonii

Post by Lorima » Sun 14 Feb 2016 14:32

Thanks!
"I have to understand the world, you see."
Richard Feynman

RitaA
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Re: Novel U.S.A. pathogenic B. burgdorferi sensu lato species - Borrelia Mayonii

Post by RitaA » Tue 29 Mar 2016 19:59

https://labtestsonline.org/news/160310lyme/
Scientists Find New Bacteria Species that Causes Lyme Disease

March 10, 2016

Scientists have recently reported finding a second species of bacteria that can cause Lyme disease. The species was discovered after lab tests from six patients in Minnesota suspected of having Lyme disease showed results that were different from what would be expected for Borrelia burgdorferi, the known cause of Lyme disease.

Genetic testing confirmed enough differences from Borrelia burgdorferi for the second bacteria to be considered a new species, which has been given the name Borrelia mayonii after the Mayo Clinic, where it was found. In a two-year period, six patients out of 9,000 people tested for Lyme disease had B. mayonii. The findings about the new bacteria were recently published in The Lancet Infectious Diseases.

B. mayonii is closely related to B. burgdorferi. Like B. burgdorferi, B. mayonii is spread by the bite of a deer tick, also called the blacklegged tick. It causes signs and symptoms similar to B. burgdorferi, including fever, headache, rash, and neck pain within a few days of infection, with joint pain and arthritis developing weeks after the tick bite.

However, B. mayonii seems to produce other symptoms, including nausea and vomiting. Most notably, instead of the signature Lyme disease "bull's eye" rash that may be found at the site of the tick bite with B. burgdorferi infections, B. mayonii may cause a rash that is more spread out (diffuse) and lacks the bull’s eye target appearance. Some of these differences may lead to missed cases of Lyme disease.

The blood tests currently used for Lyme disease should be able to diagnose the infection if it is caused by the new bacteria, according to the Centers for Disease Control and Prevention (CDC). And the good news is that patients can be treated with the same antibiotics typically prescribed for Lyme disease caused by B. burgdorferi. The six infected patients from the Mayo report who were confirmed with the new bacteria were successfully treated in this manner.

For now, cases of B. mayonii seem to be confined to the upper Midwest of the U.S. Scientists did not detect the new species in 25,000 blood samples of people in 43 states suspected of having tick-borne disease at about the same time that the new bacteria species was identified. How or when this new species appeared remains a mystery.

The CDC, along with state health departments in Minnesota, Wisconsin and North Dakota, will continue to investigate the new bacterial species and the illness it causes, and will monitor ticks carrying the new species to other parts of the country. To definitively find out if the new bacteria has caused an infection, researchers can use the polymerase chain reaction (PCR) method of testing to identify the bacteria's DNA.

[snip]

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