{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T18:47:59Z","timestamp":1792003679713,"version":"4.4.0"},"reference-count":122,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,4,3]],"date-time":"2023-04-03T00:00:00Z","timestamp":1680480000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Gordon and Llura Gund Foundation"},{"name":"Llura A. Gund Laboratory for Vector-borne Disease Research"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Borrelia miyamotoi is an emerging pathogen that causes a febrile illness and is transmitted by the same hard-bodied (ixodid) ticks that transmit several other pathogens, including Borrelia species that cause Lyme disease. B. miyamotoi was discovered in 1994 in Ixodes persulcatus ticks in Japan. It was first reported in humans in 2011 in Russia. It has subsequently been reported in North America, Europe, and Asia. B. miyamotoi infection is widespread in Ixodes ticks in the northeastern, northern Midwestern, and far western United States and in Canada. In endemic areas, human B. miyamotoi seroprevalence averages from 1 to 3% of the population, compared with 15 to 20% for B. burgdorferi. The most common clinical manifestations of B. miyamotoi infection are fever, fatigue, headache, chills, myalgia, arthralgia, and nausea. Complications include relapsing fever and rarely, meningoencephalitis. Because clinical manifestations are nonspecific, diagnosis requires laboratory confirmation by PCR or blood smear examination. Antibiotics are effective in clearing infection and are the same as those used for Lyme disease, including doxycycline, tetracycline, erythromycin, penicillin, and ceftriaxone. Preventive measures include avoiding areas where B. miyamotoi-infected ticks are found, landscape management, and personal protective strategies such as protective clothing, use of acaricides, and tick checks with rapid removal of embedded ticks.<\/jats:p>","DOI":"10.3390\/pathogens12040553","type":"journal-article","created":{"date-parts":[[2023,4,3]],"date-time":"2023-04-03T04:45:33Z","timestamp":1680497133000},"page":"553","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Human Borrelia miyamotoi Infection in North America"],"prefix":"10.3390","volume":"12","author":[{"given":"Jed","family":"Burde","sequence":"first","affiliation":[{"name":"Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT 06520, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8181-9517","authenticated-orcid":false,"given":"Evan M.","family":"Bloch","sequence":"additional","affiliation":[{"name":"Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University, Baltimore, MD 21217, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill R.","family":"Kelly","sequence":"additional","affiliation":[{"name":"Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT 06520, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3498-9454","authenticated-orcid":false,"given":"Peter J.","family":"Krause","sequence":"additional","affiliation":[{"name":"Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT 06520, USA"},{"name":"Department of Medicine, Yale School of Medicine, New Haven, CT 06510, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,4,3]]},"reference":[{"key":"ref_1","first-page":"804","article-title":"Genetic and phenotypic analysis of Borrelia miyamotoi sp. nov., Isolated from the ixodid tick Ixodes persulcatus, the vector for Lyme disease in Japan","volume":"45","author":"Fukunaga","year":"1995","journal-title":"Int. J. Syst. Evol. Microbiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1016\/j.idc.2008.03.006","article-title":"Tick-borne relapsing fever","volume":"22","author":"Dworkin","year":"2008","journal-title":"Infect. Dis. Clin. N. Am."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1097\/QCO.0b013e32832fb22b","article-title":"Current issues in relapsing fever","volume":"22","author":"Larsson","year":"2009","journal-title":"Curr. Opin. Infect. Dis."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1089\/153036601750137624","article-title":"A relapsing fever group spirochete transmitted by Ixodes scapularis ticks","volume":"1","author":"Scoles","year":"2001","journal-title":"Vector Borne Zoonotic Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1816","DOI":"10.3201\/eid1710.101474","article-title":"Humans infected with relapsing fever spirochete Borrelia miyamotoi, Russia","volume":"17","author":"Platonov","year":"2011","journal-title":"Emerg. Infect. Dis."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e772","DOI":"10.1016\/S2666-5247(22)00157-4","article-title":"Prevalence and clinical manifestation of Borrelia miyamotoi in Ixodes ticks and humans in the northern hemisphere: A systematic review and meta-analysis","volume":"3","author":"Hoornstra","year":"2022","journal-title":"Lancet Microbe"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1016\/j.cmi.2015.02.006","article-title":"Borrelia miyamotoi infection in nature and in humans","volume":"21","author":"Krause","year":"2015","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1016\/j.pt.2015.03.008","article-title":"Borrelia miyamotoi: A widespread tick-borne relapsing fever spirochete","volume":"31","author":"Wagemakers","year":"2015","journal-title":"Trends Parasitol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"236","DOI":"10.3201\/eid2402.160378","article-title":"Borrelia miyamotoi infections in humans and ticks, Northeastern China","volume":"24","author":"Jiang","year":"2018","journal-title":"Emerg. Infect. Dis."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"98","DOI":"10.3389\/fcimb.2018.00098","article-title":"Relapsing fevers: Neglected tick-borne diseases","volume":"8","author":"Boyer","year":"2018","journal-title":"Front. Cell Infect. Microbiol."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Kubiak, K., Szczotko, M., and Dmitryjuk, M. (2021). Borrelia miyamotoi\u2014An emerging human tick-borne pathogen in Europe. Microorganisms, 9.","DOI":"10.3390\/microorganisms9010154"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1016\/j.meegid.2014.04.022","article-title":"Phylogeny of a relapsing fever Borrelia species transmitted by the hard tick Ixodes scapularis","volume":"27","author":"Barbour","year":"2014","journal-title":"Infect. Genet. Evol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1016\/j.cll.2015.08.002","article-title":"Borrelia miyamotoi disease: Neither Lyme disease nor relapsing fever","volume":"35","author":"Telford","year":"2015","journal-title":"Clin. Lab. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2483","DOI":"10.1128\/jcm.34.10.2483-2492.1996","article-title":"GlpQ: An antigen for serological discrimination between relapsing fever and Lyme borreliosis","volume":"34","author":"Schwan","year":"1996","journal-title":"J. Clin. Microbiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1056\/NEJMc1215469","article-title":"Human Borrelia miyamotoi infection in the United States","volume":"368","author":"Krause","year":"2013","journal-title":"N. Engl. J. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1183","DOI":"10.3201\/eid2007.131587","article-title":"Borrelia miyamotoi sensu lato seroreactivity and seroprevalence in the northeastern United States","volume":"20","author":"Krause","year":"2014","journal-title":"Emerg. Infect. Dis."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.ttbdis.2012.06.008","article-title":"Transovarial transmission of Borrelia spirochetes by Ixodes scapularis: A summary of the literature and recent observations","volume":"4","author":"Rollend","year":"2013","journal-title":"Ticks Tick-Borne Dis."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"102003","DOI":"10.1016\/j.ttbdis.2022.102003","article-title":"A comparison of horizontal and transovarial transmission efficiency of Borrelia miyamotoi by Ixodes scapularis","volume":"13","author":"Lynn","year":"2022","journal-title":"Ticks Tick-Borne Dis."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Nakao, R., Kasama, K., Boldbaatar, B., Ogura, Y., Kawabata, H., Toyoda, A., Hayashi, T., Takano, A., and Maeda, K. (2021). The evolution of hard tick-borne relapsing fever borreliae is correlated with vector species rather than geographical distance. BMC Ecol. Evol., 21.","DOI":"10.1186\/s12862-021-01838-1"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e00713-13","DOI":"10.1128\/genomeA.00713-13","article-title":"Chromosome sequence of Borrelia miyamotoi, an uncultivable tick-borne agent of human infection","volume":"1","author":"Hue","year":"2013","journal-title":"Genome Announc."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e01424-17","DOI":"10.1128\/genomeA.01424-17","article-title":"Whole-genome sequencing of six Borrelia miyamotoi clinical strains isolated in Russia","volume":"6","author":"Kuleshov","year":"2018","journal-title":"Genome Announc."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e00960-17","DOI":"10.1128\/genomeA.00960-17","article-title":"Chromosome and large linear plasmid sequences of a Borrelia miyamotoi strain isolated from Ixodes pacificus ticks from California","volume":"5","author":"Kingry","year":"2017","journal-title":"Genome Announc."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e01557-16","DOI":"10.1128\/genomeA.01557-16","article-title":"Toward a Complete North American Borrelia miyamotoi genome","volume":"5","author":"Kingry","year":"2017","journal-title":"Genome Announc."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Barbour, A.G. (2016). Multiple and diverse vsp and vlp sequences in Borrelia miyamotoi, a hard tick-borne zoonotic pathogen. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0146283"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1007\/s00508-018-1368-2","article-title":"Microbiological features distinguishing Lyme disease and relapsing fever spirochetes","volume":"130","author":"Normark","year":"2018","journal-title":"Wien. Klin. Wochenschr."},{"key":"ref_26","first-page":"e01314-19","article-title":"Draft Whole-Genome Sequences of Two Western European Borrelia miyamotoi Isolates","volume":"8","author":"Kuleshov","year":"2019","journal-title":"Genome Announc."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Kuleshov, K.V., Margos, G., Fingerle, V., Koetsveld, J., Goptar, I.A., Markelov, M.L., Kolyasnikova, N.M., Sarksyan, D.S., Kirdyashkina, N.P., and Shipulin, G.A. (2020). Whole genome sequencing of Borrelia miyamotoi isolate Izh-4: Reference for a complex bacterial genome. BMC Genom., 21.","DOI":"10.1186\/s12864-019-6388-4"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2154","DOI":"10.1093\/jme\/tjab075","article-title":"Detection of genetic variability in Borrelia miyamotoi (Spirochaetales: Spi-rochaetaceae) between and within the eastern and western United States","volume":"58","author":"Hojgaard","year":"2021","journal-title":"J. Med. Entomol."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Krause, P.J., Carroll, M., Fedorova, N., Brancato, J., Dumouchel, C., Akosa, F., Narasimhan, S., Fikrig, E., and Lane, R.S. (2018). Human Borrelia miyamotoi infection in California: Serodiagnosis is complicated by multiple endemic Borrelia species. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0191725"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1097\/IPC.0000000000000509","article-title":"Borrelia miyamotoi polymerase chain reaction positivity on a tick-borne disease panel in an endemic region of Rhode Island: A case series","volume":"25","author":"Fiorito","year":"2017","journal-title":"Infect. Dis. Clin. Pract."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e00151-17","DOI":"10.1128\/mSphere.00151-17","article-title":"Detection of Anaplasma phagocytophilum, Babesia microti, Borrelia burgdorferi, Borrelia miyamotoi, and Powassan virus in ticks by a multiplex real-time reverse transcription-PCR assay","volume":"2","author":"Tokarz","year":"2017","journal-title":"Msphere"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2397","DOI":"10.1056\/NEJMra1202018","article-title":"Human babesiosis","volume":"366","author":"Vannier","year":"2012","journal-title":"N. Engl. J. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1146\/annurev.en.30.010185.002255","article-title":"Ecology of Ixodes Dammini-borne human babesiosis and Lyme Disease","volume":"30","author":"Spielman","year":"1985","journal-title":"Annu. Rev. \u00c8ntomol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1120","DOI":"10.4269\/ajtmh.2009.09-0208","article-title":"Niche Partitioning of Borrelia burgdorferi and Borrelia miyamotoi in the same tick vector and mammalian reservoir species","volume":"81","author":"Barbour","year":"2009","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1016\/j.ttbdis.2014.07.001","article-title":"Tick-borne pathogens in ticks collected from breeding and migratory birds in Switzerland","volume":"5","author":"Lommano","year":"2014","journal-title":"Ticks Tick-Borne Dis."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1089\/vbz.2012.1027","article-title":"Borrelia miyamotoi infections among wild rodents show age and month independence and correlation with Ixodes persulcatus larval attachment in Hokkaido, Japan","volume":"13","author":"Taylor","year":"2013","journal-title":"Vector-Borne Zoonotic Dis."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1186\/1756-3305-7-233","article-title":"Genetic characterization of the human relapsing fever spirochete Borrelia miyamotoi in vectors and animal reservoirs of Lyme disease spirochetes in France","volume":"7","author":"Cosson","year":"2014","journal-title":"Parasites Vectors"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"101637","DOI":"10.1016\/j.ttbdis.2020.101637","article-title":"Prevalence of single and coinfections of human pathogens in Ixodes ticks from five geographical regions in the United States, 2013\u20132019","volume":"12","author":"Lehane","year":"2021","journal-title":"Ticks Tick Borne Dis."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"101556","DOI":"10.1016\/j.ttbdis.2020.101556","article-title":"Seasonality of acarological risk of exposure to Borrelia miyamotoi from questing life stages of Ixodes scapularis collected from Wisconsin and Massachusetts, USA","volume":"12","author":"Han","year":"2020","journal-title":"Ticks Tick-Borne Dis."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1089\/vbz.2009.0036","article-title":"Assessment of polymicrobial infections in ticks in New York state","volume":"10","author":"Tokarz","year":"2010","journal-title":"Vector-Borne Zoonotic Dis."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"812","DOI":"10.1016\/j.ttbdis.2015.07.009","article-title":"Relatively low prevalence of Babesia microti and Anaplasma phagocytophilum in Ixodes scapularis ticks collected in the Lehigh Valley region of eastern Pennsylvania","volume":"6","author":"Edwards","year":"2015","journal-title":"Ticks Tick-Borne Dis."},{"key":"ref_42","first-page":"742","article-title":"Prevalence and diversity of tick-borne pathogens in Nymphal Ixodes scapularis(Acari: Ixodidae) in eastern national parks","volume":"54","author":"Johnson","year":"2016","journal-title":"J. Med. \u00c8ntomol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1230","DOI":"10.1016\/j.ttbdis.2016.07.009","article-title":"Paired real-time PCR assays for detection of Borrelia miyamotoi in North American Ixodes scapularis and Ixodes pacificus (Acari: Ixodidae)","volume":"7","author":"Graham","year":"2016","journal-title":"Ticks Tick-Borne Dis."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1496","DOI":"10.1093\/jme\/tjy111","article-title":"Landscape features associated with blacklegged tick (Acari: Ixodidae) density and tick-borne pathogen prevalence at multiple spatial scales in central New York state","volume":"55","author":"Piedmonte","year":"2018","journal-title":"J. Med. \u00c8ntomol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1122","DOI":"10.1093\/jme\/tjz043","article-title":"A 4-yr survey of the range of ticks and tick-borne pathogens in the Lehigh Valley Region of Eastern Pennsylvania","volume":"56","author":"Edwards","year":"2019","journal-title":"J. Med. \u00c8ntomol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"e02055-19","DOI":"10.1128\/mBio.02055-19","article-title":"Polymicrobial nature of tick-borne diseases","volume":"10","author":"Tagliafierro","year":"2019","journal-title":"Mbio"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1186\/s13071-018-2623-0","article-title":"Multiflora rose invasion amplifies prevalence of Lyme disease pathogen, but not necessarily Lyme disease risk","volume":"11","author":"Adalsteinsson","year":"2018","journal-title":"Parasites Vectors"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1678","DOI":"10.3201\/eid2010.131583","article-title":"Prevalence of Borrelia miyamotoi in Ixodes ticks in Europe and the United States","volume":"20","author":"Crowder","year":"2014","journal-title":"Emerg. Infect. Dis."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1499","DOI":"10.1016\/j.ttbdis.2018.07.009","article-title":"Prevalence and distribution of seven human pathogens in host-seeking Ixodes scapularis (Acari: Ixodidae) nymphs in Minnesota, USA","volume":"9","author":"Johnson","year":"2018","journal-title":"Ticks Tick-Borne Dis."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1016\/j.ttbdis.2017.11.010","article-title":"Evaluating acarological risk for exposure to Ixodes scapularis and Ixodes scapularis-borne pathogens in recreational and residential settings in Washington County, Minnesota","volume":"9","author":"Hahn","year":"2018","journal-title":"Ticks Tick-Borne Dis."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1093\/jme\/tjx258","article-title":"Prevalence and geographic distribution of Borrelia miyamotoi in host-seeking Ixodes pacificus (Acari: Ixodidae) nymphs in Mendocino County, California","volume":"55","author":"Lynn","year":"2018","journal-title":"J. Med. \u00c8ntomol."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Eshoo, M.W., Carolan, H.E., Massire, C., Chou, D.M., Crowder, C.D., Rounds, M.A., Phillipson, C.A., Schutzer, S.E., and Ecker, D.J. (2015). Survey of Ixodes pacificus ticks in California reveals a diversity of microorganisms and a novel and widespread Anaplasmataceae species. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0135828"},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Padgett, K., Bonilla, D., Kjemtrup, A., Vilcins, I.-M., Yoshimizu, M.H., Hui, L., Sola, M., Quintana, M., and Kramer, V. (2014). Large scale spatial risk and comparative prevalence of Borrelia miyamotoi and Borrelia burgdorferi sensu lato in Ixodes pacificus. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0110853"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"493","DOI":"10.3201\/eid2003.130668","article-title":"Tick-borne pathogens in northwestern California, USA","volume":"20","author":"Salkeld","year":"2014","journal-title":"Emerg. Infect. Dis."},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Salkeld, D.J., Nieto, N.C., Carbajales-Dale, P., Carbajales-Dale, M., Cinkovich, S.S., and Lambin, E.F. (2015). Disease risk & landscape attributes of tick-borne Borrelia pathogens in the San Francisco Bay area, California. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0134812"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"951","DOI":"10.1016\/j.ttbdis.2014.07.015","article-title":"Remarkable diversity of tick or mammalian-associated Borreliae in the metropolitan San Francisco Bay area, California","volume":"5","author":"Fedorova","year":"2014","journal-title":"Ticks Tick-Borne Dis."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"648","DOI":"10.3201\/eid2604.191382","article-title":"Ecology and epidemiology of tickborne pathogens, Washington, USA, 2011\u20132016","volume":"26","author":"Dykstra","year":"2020","journal-title":"Emerg. Infect. Dis."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1093\/jmedent\/43.1.120","article-title":"Detection of a Borrelia miyamotoi sensu lato relapsing-fever group spirochete from Ixodes pacificus in California","volume":"43","author":"Mun","year":"2006","journal-title":"J. Med. \u00c8ntomol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"ciac107","DOI":"10.1093\/cid\/ciac107","article-title":"Geographic dispersion of Borrelia miyamotoi, Borrelia burgdorferi and Babesia microti in New England","volume":"23","author":"Johnston","year":"2022","journal-title":"Clin. Inf. Dis."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.ttbdis.2013.02.005","article-title":"Eco-epidemiological factors contributing to the low risk of human exposure to ixodid tick-borne borreliae in southern California, USA","volume":"4","author":"Lane","year":"2013","journal-title":"Ticks Tick-Borne Dis."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"1328","DOI":"10.1093\/jme\/tjac049","article-title":"Reported county-level distribution of seven human pathogens detected in host-seeking Ixodes scapularis and Ixodes pacificus (Acari: Ixodidae) in the contiguous United States","volume":"59","author":"Fleshman","year":"2022","journal-title":"J. Med. \u00c8ntomol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1016\/j.meegid.2014.06.003","article-title":"Increased diversity of zoonotic pathogens and Borrelia burgdorferi strains in established versus incipient Ixodes scapularis populations across the midwestern United States","volume":"27","author":"Hamer","year":"2014","journal-title":"Infect. Genet Evol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"316","DOI":"10.3201\/eid2202.151218","article-title":"High prevalence of Borrelia miyamotoi among adult blacklegged ticks from white-tailed deer","volume":"22","author":"Han","year":"2016","journal-title":"Emerg. Infect. Dis."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1186\/s13071-020-04569-2","article-title":"Spatial and temporal patterns of the emerging tick-borne pathogen Borrelia miyamotoi in blacklegged ticks (Ixodes scapularis) in New York","volume":"14","author":"Keesing","year":"2021","journal-title":"Parasites Vectors"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1089\/vbz.2019.2551","article-title":"Detection of Babesia, Borrelia, Anaplasma, and Rickettsia spp. in adult black-legged ticks (Ixodes scapularis) from Pennsylvania, United States, with a Luminex Multiplex Bead Assay","volume":"20","author":"Livengood","year":"2020","journal-title":"Vector Borne Zoonotic Dis."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"894","DOI":"10.1016\/j.ttbdis.2019.04.011","article-title":"Microbiome analysis of Ixodes scapularis ticks from New York and Connecticut","volume":"10","author":"Tokarz","year":"2019","journal-title":"Ticks Tick Borne Dis."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"1352","DOI":"10.1093\/jme\/tjaa291","article-title":"Surveillance of ticks and tick-borne pathogens in suburban natural habitats of central Maryland","volume":"58","author":"Milholland","year":"2021","journal-title":"J. Med. \u00c8ntomol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"3193","DOI":"10.3201\/eid2712.204646","article-title":"Borrelia miyamotoi in human-biting ticks, United States, 2013\u20132019","volume":"27","author":"Xu","year":"2021","journal-title":"Emerg Infect Dis."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1016\/j.ttbdis.2011.07.002","article-title":"Novel exposure sites for nymphal Ixodes pacificus within picnic areas","volume":"2","author":"Padgett","year":"2011","journal-title":"Ticks Tick-Borne Dis."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1016\/j.ttbdis.2017.01.004","article-title":"Detection of Borrelia miyamotoi and other tick-borne pathogens in human clinical specimens and Ixodes scapularis ticks in New York State, 2012\u20132015","volume":"8","author":"Wroblewski","year":"2017","journal-title":"Ticks Tick-Borne Dis."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"804","DOI":"10.3201\/eid2504.180202","article-title":"Seroprevalence of Borrelia burgdorferi, B. miyamotoi, and Powassan virus in residents bitten by Ixodes ticks, Maine, USA","volume":"25","author":"Smith","year":"2019","journal-title":"Emerg Infect Dis."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1186\/1756-3305-7-183","article-title":"The prevalence of Borrelia miyamotoi infection, and co-infections with other Borrelia spp. in Ixodes scapularis ticks collected in Canada","volume":"7","author":"Dibernardo","year":"2014","journal-title":"Parasites Vectors"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1089\/vbz.2015.1890","article-title":"Distribution of ticks and the risk of Lyme disease and other tick-borne pathogens of public health significance in Ontario, Canada","volume":"16","author":"Clow","year":"2016","journal-title":"Vector-Borne Zoonotic Dis."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1016\/j.ttbdis.2019.02.016","article-title":"Babesia odocoilei and zoonotic pathogens identified from Ixodes scapularis ticks in southern Ontario, Canada","volume":"10","author":"Milnes","year":"2019","journal-title":"Ticks Tick-Borne Dis."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"237","DOI":"10.14745\/ccdr.v44i10a02","article-title":"Ixodes scapularis tick distribution and infection rates in Ottawa, Ontario, 2017","volume":"44","author":"Kulkarni","year":"2018","journal-title":"Can. Commun. Dis. Rep."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1186\/s13071-021-04750-1","article-title":"Monitoring the patterns of submission and presence of tick-borne pathogens in Ixodes scapularis collected from humans and companion animals in Ontario, Canada (2011\u20132017)","volume":"14","author":"Nelder","year":"2021","journal-title":"Parasites Vectors"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"944","DOI":"10.1111\/zph.12992","article-title":"Spatial patterns of Borrelia burgdorferi, Borrelia miyamotoi and Anaplasma phagocytophilum detected in Ixodes spp. ticks from Canadian companion animals, 2019\u20132020","volume":"69","author":"Jacob","year":"2022","journal-title":"Zoonoses Public Health"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"354","DOI":"10.14745\/ccdr.v46i10a08","article-title":"Sentinel surveillance of Lyme disease risk in Canada, 2019: Results from the first year of the Canadian Lyme Sentinel Network (CaLSeN)","volume":"46","author":"Guillot","year":"2020","journal-title":"Can. Commun. Dis. Rep."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"E690","DOI":"10.9778\/cmajo.20170070","article-title":"Human seroprevalence of Borrelia miyamotoi in Manitoba, Canada: 2011\u20132014. A cross sectional study","volume":"5","author":"Kadkhoda","year":"2017","journal-title":"CMAJ Open"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"1536","DOI":"10.1093\/jme\/tjaa220","article-title":"Possible effects of climate change on Ixodid ticks and the pathogens they transmit: Predictions and observations","volume":"58","author":"Ogden","year":"2020","journal-title":"J. Med. \u00c8ntomol."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1146\/annurev-ento-052720-094533","article-title":"The impacts of climate change on ticks and tick-borne disease Risk","volume":"66","author":"Gilbert","year":"2021","journal-title":"Annu. Rev. \u00c8ntomol."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1093\/jme\/tjv199","article-title":"Linkages of weather and climate with Ixodes scapularis and Ixodes pacificus(Acari: Ixodidae), enzootic transmission of Borrelia burgdorferi, and Lyme disease in North America","volume":"53","author":"Eisen","year":"2015","journal-title":"J. Med. \u00c8ntomol."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1007\/s10393-004-0139-x","article-title":"Effect of climate change on Lyme disease risk in North America","volume":"2","author":"Brownstein","year":"2005","journal-title":"EcoHealth"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"431","DOI":"10.4269\/ajtmh.2003.68.431","article-title":"Increasing health burden of human babesiosis in endemic sites","volume":"68","author":"Krause","year":"2003","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1016\/j.idc.2022.03.004","article-title":"Epidemiology of Lyme disease","volume":"36","author":"Mead","year":"2022","journal-title":"Infect. Dis. Clin. N. Am."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"91","DOI":"10.7326\/M15-0333","article-title":"Borrelia miyamotoi disease in the northeastern United States: A case series","volume":"163","author":"Molloy","year":"2015","journal-title":"Ann. Intern. Med."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"1770","DOI":"10.3201\/eid2409.180806","article-title":"Borrelia miyamotoi disease in an immunocompetent patient, western Europe","volume":"24","author":"Hoornstra","year":"2018","journal-title":"Emerg Infect Dis."},{"key":"ref_88","first-page":"35","article-title":"Clinical presentation of Ixodes tick-borne borreliosis caused by Borrelia miyamotoi in the context of an immune response to the pathogen","volume":"89","author":"Platonov","year":"2017","journal-title":"Ter. Arkhiv"},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"860","DOI":"10.3201\/eid2405.170829","article-title":"Dynamics of spirochetemia and early PCR detection of Borrelia miyamotoi","volume":"24","author":"Karan","year":"2018","journal-title":"Emerg. Infect. Dis."},{"key":"ref_90","first-page":"34","article-title":"Clinical presentation of \u201cnew\u201d tick-borne borreliosis caused by Borrelia miyamotoi","volume":"84","author":"Sarksyan","year":"2012","journal-title":"Ter. Arkhiv"},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"18","DOI":"10.17116\/terarkh2015871118-25","article-title":"Relapsing (recurrent) disease caused by Borrelia miyamotoi","volume":"87","author":"Sarksyan","year":"2015","journal-title":"Ter. Arkh."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"1657","DOI":"10.1001\/jama.1996.03530450047031","article-title":"Concurrent Lyme disease and babesiosis. Evidence for increased severity and duration of illness","volume":"275","author":"Krause","year":"1996","journal-title":"JAMA"},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"1184","DOI":"10.1086\/339813","article-title":"Disease-specific diagnosis of coinfecting tickborne zoonoses: Babesiosis, human granulocytic ehrlichiosis, and Lyme disease","volume":"4","author":"Krause","year":"2002","journal-title":"Clin. Infect. Dis."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1093\/cid\/cis852","article-title":"Lyme disease and human granulocytic anaplasmosis coinfection: Impact of case definition on coinfection rates and illness severity","volume":"56","author":"Horowitz","year":"2012","journal-title":"Clin. Infect. Dis."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"1078","DOI":"10.1086\/368187","article-title":"Prospective study of coinfection in patients with erythema migrans","volume":"36","author":"Steere","year":"2003","journal-title":"Clin Infect Dis."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"1391","DOI":"10.3201\/eid2008.131761","article-title":"Human infections with Borrelia miyamotoi, Japan","volume":"20","author":"Sato","year":"2014","journal-title":"Emerg. Infect. Dis."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"1471","DOI":"10.3201\/eid2208.151878","article-title":"Borrelia miyamotoi infection in patients from upper midwestern United States, 2014\u20132015","volume":"22","author":"Jobe","year":"2016","journal-title":"Emerg. Infect. Dis."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1186\/s12941-020-00364-0","article-title":"Presence of Borrelia miyamotoi infection in a highly endemic area of Lyme disease","volume":"19","author":"Marcos","year":"2020","journal-title":"Ann. Clin. Microbiol. Antimicrob."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"1578","DOI":"10.1056\/NEJMcpc2004996","article-title":"Case 32-2020: A 63-Year-Old Man with confusion, fatigue, and garbled speech","volume":"383","author":"Mukerji","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"ofac295","DOI":"10.1093\/ofid\/ofac295","article-title":"Borrelia miyamotoi meningoencephalitis in an immunocompetent patient","volume":"9","author":"Gandhi","year":"2022","journal-title":"Open Forum Infect. Dis."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1016\/S0140-6736(13)61644-X","article-title":"A case of meningoencephalitis by the relapsing fever spirochaete Borrelia miyamotoi in Europe","volume":"382","author":"Hovius","year":"2013","journal-title":"Lancet"},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"1617","DOI":"10.3201\/eid2209.152034","article-title":"Borrelia miyamotoi-associated neuroborreliosis in immunocompromised person","volume":"22","author":"Boden","year":"2016","journal-title":"Emerg. Infect. Dis."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"1965","DOI":"10.3201\/eid2510.190416","article-title":"Two cases of Borrelia miyamotoi meningitis, Sweden, 2018","volume":"25","author":"Henningsson","year":"2019","journal-title":"Emerg. Infect Dis."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"2201","DOI":"10.3201\/eid2609.191501","article-title":"Human Borrelia miyamotoi infection, Austria","volume":"26","author":"Tobudic","year":"2020","journal-title":"Emerg. Infect. Dis."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1056\/NEJMoa1209039","article-title":"Meningoencephalitis from Borrelia miyamotoi in an immunocompromised patient","volume":"368","author":"Gugliotta","year":"2013","journal-title":"N. Engl. J. Med."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1046\/j.1537-2995.1990.30490273451.x","article-title":"Blood transfusion-associated relapsing fever","volume":"30","author":"Nadelman","year":"1990","journal-title":"Transfusion"},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1111\/trf.12879","article-title":"Blood transfusion transmission of the tick borne relapsing fever spirochete Borrelia miyamotoi in mice","volume":"55","author":"Krause","year":"2015","journal-title":"Transfusion"},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1111\/trf.13398","article-title":"Distribution and survival of Borrelia miyamotoi in human blood components","volume":"56","author":"Thorp","year":"2016","journal-title":"Transfusion"},{"key":"ref_109","doi-asserted-by":"crossref","unstructured":"Brummitt, S.I., Kjemtrup, A.M., Harvey, D.J., Petersen, J.M., Sexton, C., Replogle, A., Packham, A.E., Bloch, E.M., Barbour, A.G., and Krause, P.J. (2020). Borrelia burgdorferi and Borrelia miyamotoi seroprevalence in California blood donors. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0243950"},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1002\/nmi2.59","article-title":"High seroprevalence of Borrelia miyamotoi antibodies in forestry workers and individuals suspected of human granulocytic anaplasmosis in the Netherlands","volume":"2","author":"Jahfari","year":"2014","journal-title":"New Microbes New Infect."},{"key":"ref_111","doi-asserted-by":"crossref","unstructured":"Reiter, M., Stelzer, T., Schotta, A.M., Markowicz, M., Leschnik, M., Harsch, A., Rei\u00df, E., Kneusel, R.E., Stockinger, H., and Stanek, G. (2020). Glycerophosphodiester phosphodiesterase identified as non-reliable serological marker for Borrelia miyamotoi disease. Microorganisms, 8.","DOI":"10.3390\/microorganisms8121846"},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1503\/cmaj.122053","article-title":"Tick-borne relapsing fever in pregnancy","volume":"186","author":"Hussein","year":"2013","journal-title":"Can. Med. Assoc. J."},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1056\/NEJMcpc1501763","article-title":"Case 24-2015\u2014A 28-year-old pregnant woman with fever, chills, headache, and fatigue","volume":"373","author":"Hu","year":"2015","journal-title":"N. Engl. J. Med."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"4185","DOI":"10.4049\/jimmunol.1600014","article-title":"Variable major proteins as targets for specific antibodies against Borrelia miyamotoi","volume":"196","author":"Wagemakers","year":"2016","journal-title":"J. Immunol."},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"1338.e1","DOI":"10.1016\/j.cmi.2018.03.009","article-title":"Serodiagnosis of Borrelia miyamotoi disease by measuring antibodies against GlpQ and variable major proteins","volume":"24","author":"Koetsveld","year":"2018","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"e02036-22","DOI":"10.1128\/spectrum.02036-22","article-title":"Development and validation of a protein array for detection of antibodies against the tick-borne pathogen Borrelia miyamotoi","volume":"10","author":"Hoornstra","year":"2022","journal-title":"Microbiol. Spectr."},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.diagmicrobio.2016.06.015","article-title":"Insights into Borrelia miyamotoi infection from an untreated case demonstrating relapsing fever, monocytosis and a positive C6 Lyme serology","volume":"86","author":"Sudhindra","year":"2016","journal-title":"Diagn. Microbiol. Infect. Dis."},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"2424","DOI":"10.1056\/NEJMra021397","article-title":"How can we prevent Lyme disease?","volume":"348","author":"Hayes","year":"2003","journal-title":"N. Engl. J. Med."},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.1093\/jme\/tjw103","article-title":"Evidence for personal protective measures to reduce human contact with blacklegged ticks and for environmentally based control methods to suppress host-seeking blacklegged ticks and reduce infection with Lyme disease spirochetes in tick vectors and rodent reservoirs","volume":"53","author":"Eisen","year":"2016","journal-title":"J. Med. Entomol."},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"20160117","DOI":"10.1098\/rstb.2016.0117","article-title":"Lyme disease ecology in a changing world: Consensus, uncertainty and critical gaps for improving control","volume":"372","author":"Kilpatrick","year":"2017","journal-title":"Philos. Trans. R. Soc. B Biol. Sci."},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"1588","DOI":"10.1093\/jme\/tjaa079","article-title":"Barriers to effective tick management and tick-bite prevention in the United States (Acari: Ixodidae)","volume":"58","author":"Eisen","year":"2020","journal-title":"J. Med. \u00c8ntomol."},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1086\/318818","article-title":"Effect of tick removal on transmission of Borrelia burgdorferi and Ehrlichia phagocytophila by Ixodes scapularis nymphs","volume":"183","author":"Piesman","year":"2001","journal-title":"J. Infect. Dis."}],"container-title":["Pathogens"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-0817\/12\/4\/553\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:08:56Z","timestamp":1760123336000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-0817\/12\/4\/553"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,3]]},"references-count":122,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2023,4]]}},"alternative-id":["pathogens12040553"],"URL":"https:\/\/doi.org\/10.3390\/pathogens12040553","relation":{},"ISSN":["2076-0817"],"issn-type":[{"value":"2076-0817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,3]]}}}