A tick-borne disease so new it only has a scientific name has been identified in United States patients for the first time, including at least one person from Nantucket. Borrelia miyamotoi is a relative of Lyme disease with similar symptoms including fever, headache, muscle ache, and fatigue.
Unlike Lyme disease, B. miyamotoi presents recurring fevers in patients and does not trigger a bulls-eye rash. Nor does it cause a positive test with traditional Lyme disease testing, said Dr. Sam R. Telford 3rd, a professor of infectious diseases at Tufts University.
“This has been a bone of contention with a subset of patients who say ‘I had Lyme disease, but I’ve never tested positive,’” said Dr. Telford. “Now there’s a legitimate scenario for that to happen.”
Dr. Telford said Imugen Inc., a clinical laboratory based in Norwood, could have an antibody test for B. miyamotoi available by summer, just in time for what he refers to as “tick season.”
A recent study from the Yale Schools of Public Health and Medicine in the New England Journal of Medicine reported evidence of B. miyamotoi in 18 case study patients tested in southern New England and New York. The patients’ blood samples dated back to 1990.
“Though the disease is heralded as new,” said Dr. Gerry Yukevich, “it has probably been around for at least several decades, and presumably the affliction has existed here on the Vineyard for an equal period of time. . . . I suspect the illness has been around and we have been treating it as Lyme Disease or babesiosis. But it’s hard for me to comment on an illness I’m not sure I’ve ever seen.”
In 2011 Dr. Telford detected B. miyamotoi in one to three per cent of deer ticks analyzed in southeastern Massachusetts, including on the Cape and Islands. But at the time it had not been proven that the disease could be transferred to humans.
“It’s not new, it’s been under our nose all along,” he said. The bacterium was first discovered in 1995, but only in 2011 did Yale scientists find evidence of human infection caused by the bacterium in Russian case study patients.
“Now it’s finally been associated with human disease,” Mr. Telford said.
B. miyamotoi can be prevented and treated in the same manner as Lyme disease with a short course of doxycycline and amoxicillin.
“It doesn’t change the approach to the patient significantly,” said Dr. Yukevich. “The same principles will apply. Acute Lyme disease is often a clinical diagnosis, rather than a laboratory diagnosis.”
Doctors typically diagnose Lyme disease based on symptoms rather than blood tests, he explained.
All agree the discovery of the human infection for B. miyamotoi presses for better prevention of tick bites and more thorough analysis of tick-borne diseases endemic on the Cape and Islands.
Tisbury board of health member Michael Loberg, along with Edgartown board of health agent Matt Poole, head a public health initiative focused on preventing incidences, educating the public and collecting more accurate data for tick-borne diseases on the Vineyard.
“It’s not like we need another reason to do something about deer ticks,” Mr. Telford added. “Lyme disease is sufficient enough.”