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Human disease caused by <jats:italic>B. miyamotoi<\/jats:italic> was first described in Russia and later in the USA and Japan. Additionally, five cases of meningoencephalitis in immunocompromised patients and one case in an apparently immunocompetent patient were described.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>We investigated the presence of <jats:italic>B. miyamotoi<\/jats:italic> in <jats:italic>I. ricinus<\/jats:italic> nymphs and in patients suspected of human granulocytic anaplasmosis, in Alsace (France), an endemic area for <jats:italic>I. ricinus<\/jats:italic> ticks and Lyme borreliosis, using direct (PCR) and indirect diagnosis (glycerophosphoryldiester-phosphodiesterase (GlpQ) serology).<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p><jats:italic>Borrelia miyamotoi<\/jats:italic> was found in 2.2% of 4354 ticks collected between 2013 and 2016. None of the 575 blood samples, collected from the patients suspected of HGA, was found positive for <jats:italic>B. miyamotoi<\/jats:italic> by PCR. Acute and late sera from 138 of these 575 patients were available. These paired sera were tested for IgM and IgG antibodies against the <jats:italic>B. miyamotoi<\/jats:italic> GlpQ antigen. A total of 14 out of 138 patients had at least one positive parameter (i.e. anti-GlpQ IgG and\/or IgM). One patient seroconverted for IgG, and three had isolated IgM in the acute serum. These three patients were treated with doxycycline which could have prevented seroconversion. After reviewing clinical data and other biological tests performed, co-exposure among different microorganisms vectored by ticks or serological cross-reactivity could not be ruled out in these different cases. One patient had persistent IgG, which strongly suggests previous exposure to <jats:italic>B. miyamotoi<\/jats:italic>.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Humans can be exposed to <jats:italic>B. miyamotoi<\/jats:italic> through tick bites in Alsace. We present serological data for possible <jats:italic>B. miyamotoi<\/jats:italic> exposure or infection of patients with fever after tick bite. Future studies should determine the incidence, clinical course and burden of this emerging tick-borne disease in other parts of Western Europe.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s13071-020-04071-9","type":"journal-article","created":{"date-parts":[[2020,4,17]],"date-time":"2020-04-17T16:03:46Z","timestamp":1587139426000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Assessment of Borrelia miyamotoi in febrile patients and ticks in Alsace, an endemic area for Lyme borreliosis in France"],"prefix":"10.1186","volume":"13","author":[{"given":"Pierre H.","family":"Boyer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joris","family":"Koetsveld","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurence","family":"Zilliox","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hein","family":"Sprong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c9milie","family":"Talagrand-Reboul","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yves","family":"Hansmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvie Josiane","family":"de Martino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathalie","family":"Boulanger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joppe W.","family":"Hovius","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beno\u00eet","family":"Jaulhac","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,4,17]]},"reference":[{"key":"4071_CR1","doi-asserted-by":"publisher","first-page":"631","DOI":"10.1016\/j.cmi.2015.02.006","volume":"21","author":"PJ Krause","year":"2015","unstructured":"Krause PJ, Fish D, Narasimhan S, Barbour AG. 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