Relapsing Fever

[LymeEnigma]

www.nlm.nih.gov/medlineplus/ency/article/001350.htm#Treatment

[enochroot]

Thanks for this and all the other "heads up" listings on possible diseases!

[LymeEnigma]

My pleasure!

[LymeEnigma]

The University of Texas on Borrelia:
www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=mmed.section.1965

This article gives a great overview on the most common forms of Borrelia. It does nothing to cover the Lyme controversy, but still the article is top notch. Here's a few snippets for you:

Borrelia has morphologic characteristics similar to those of Leptospira, except that cells average 0.2 to 0.5 μm by 4 to 18 μm and have fewer coils (Fig. 35-5). Seven to twenty periplasmic flagella originate at each end and overlap at the center of the cell. In contrast to the Leptospira peptidoglycan, that of Borrelia contains ornithine rather than diaminopimelic acid. Basal bodies of periplasmic flagella of borreliae resemble those in Gram-positive bacteria. Because of their larger diameter, borreliae are more readily stained with aniline dyes than are other spirochetes. Their lipid components are unusual in that they include cholesterol; this substance has been found in only one other bacterial genus, Mycoplasma. The nutritional requirements of the borreliae are more complex than those of leptospires. Glucose, amino acids, long-chain fatty acids, N-acetylglucosamine, and several vitamins are some of their required organic nutrients. The borreliae are microaerophilic organisms. Borrelia hermsii has a generation time of 12 hours when cultivated in artificial media at 35°C compared with only 6 to 10 hours in the mouse.

In most cases, borreliae must rely on an insect vector to transmit the organisms through the epidermis (Fig. 35-4). The site of entry is usually not prominent as the organisms are not clinically recognized until they enter the blood. The mechanisms by which they reach the bloodstream are unknown. The relapses are due to the ability of borreliae to undergo multiple cyclic antigenic variations (Fig. 35-6). As antibodies for the predominant antigenic type multiplying within the host appear, these organisms “disappear” from the peripheral blood and are replaced by a different antigenic variant within a few days. This process may occur several times in an untreated host, depending on the infecting Borrelia strain.

The mechanism by which borreliae cause Lyme disease has not been elucidated. Early Lyme disease is characterized by an expanding annular red rash, erythema migrans, in approximately 70 percent of patients, which is frequently accompanied by fever, fatigue, headache, and muscle and joint pain. Arthritis, neuritis, and carditis may also be present during early Lyme disease. Persistent neurologic and arthritic infections (lasting for months to years) may occur in some patients. In contrast to the relapsing fevers, there are very few spirochetes in Lyme disease, but viable B burgdorferi organisms are necessary for the disease to manifest itself. Although the disease has the same general features in the United States and Europe, arthritis occurs more frequently in the former and neurologic disease in the latter (emphasis mine).

[LymeEnigma]

Detection of a Borrelia miyamotoi sensu lato relapsing-fever group spirochete from Ixodes pacificus in California.
Mun J, Eisen RJ, Eisen L, Lane RS.

Division of Insect Biology, 201 Wellman Hall, University of California, Berkeley, CA 94720-3112, USA. [e-mail]

We investigated whether host-seeking nymphs and adults of the western blacklegged tick, Ixodes pacificus Cooley & Kohls, the primary vector of Lyme disease spirochetes in far-western North America, are infected naturally with relapsing-fever group spirochetes in Mendocino County, California. Relapsing-fever group borreliae were detected in four (1.7%) of 234 nymphal and two (0.7%) of 282 adult host-seeking I. pacificus ticks by polymerase chain reaction and sequence analysis of the 16S rRNA and flagellin genes, respectively, exhibiting 99 and 98.5% sequence homology to Borrelia miyamotoi Fukunaga. Phylogenetic analysis based on these two genes revealed that the borreliae detected in these ticks belong to the relapsing-fever group and that these are closely related to, if not identical with, B. miyamotoi.

PMID: 16506458 [PubMed - indexed for MEDLINE]
www.ncbi.nlm.nih.gov/pubmed/16506458?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlusDrugs1

A relapsing fever group spirochete transmitted by Ixodes scapularis ticks.
Scoles GA, Papero M, Beati L, Fish D.

Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT 06520-8034, USA.

A species of Borrelia spirochetes previously unknown from North America has been found to be transmitted by Ixodes scapularis ticks. Infected ticks are positive for Borrelia spp. by DFA test but negative for Borrelia burgdorferi by polymerase chain reaction (PCR) using species-specific primers for 16S rDNA, outer surface protein A, outer surface protein C, and flagellin genes. A 1,347-bp portion of 16S rDNA was amplified from a pool of infected nymphs, sequenced, and compared with the homologous fragment from 26 other species of Borrelia. The analysis showed 4.6% pairwise difference from B. burgdorferi, with the closest relative being Borrelia miyamotoi (99.3% similarity) reported from Ixodes persulcatus in Japan. Phylogenetic analysis showed the unknown Borrelia to cluster with relapsing fever group spirochetes rather than with Lyme disease spirochetes. A 764-bp fragment of the flagellin gene was also compared with the homologous fragment from 24 other Borrelia species. The flagellin sequence of B. burgdorferi was 19.5% different from the unknown Borrelia and showed 98.6% similarity with B. miyamotoi. A pair of PCR primers specifically designed to amplify a 219-bp fragment of the flagellin gene from this spirochete was used to survey field-collected I. scapularis nymphs from five northeastern states (Connecticut, Rhode Island, New York, New Jersey, and Maryland). Positive results were obtained in 1.9-2.5% of 712 nymphs sampled from four states but in none of 162 ticks collected from Maryland. Transovarial transmission was demonstrated by PCR of larval progeny from infected females with filial infection rates ranging from 6% to 73%. Transstadial passage occurred from larvae through adults. Vertebrate infection was demonstrated by feeding infected nymphs on Peromyscus leucopus mice and recovering the organism from uninfected xenodiagnostic larvae fed 7-21 days later. Considering the frequency of contact between I. scapularis and humans, further work is needed to determine the potential public health significance of yet another zoonotic agent transmitted by this tick species.

PMID: 12653133 [PubMed - indexed for MEDLINE]
www.ncbi.nlm.nih.gov/pubmed/12653133?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlusDrugs1

Columbian black-tailed deer (Odocoileus hemionus columbianus) as hosts for Borrelia spp. in northern California.
Lane RS, Mun J, Parker JM, White M.

Division of Insect Biology, University of California, Berkeley, California 94720, USA. [e-mail]

The prevalence of infection of Columbian black-tailed deer (Odocoileus hemionus columbianus) with Borrelia spp. was evaluated in an area of northwestern California (USA) where Lyme disease is endemic and the relapsing-fever group spirochete Borrelia coriaceae is enzootic, and in a far-removed comparison area having a disparate climate and lower density of vector ticks. Blood samples collected from both deer herds in 1987, 1988, and from 2000-02 were assayed for borrelial infection with microscopic and molecular methods. Serum specimens from two (5%) of 39 deer from the Dye Creek Preserve in Tehama County versus 13 (20%) of 64 animals from the Hopland Research and Extension Center (HREC) in Mendocino County, California were polymerase chain reaction (PCR) test positive for B. burgdorferi sensu lato. DNA sequencing analyses revealed that eight animals were infected with B. bissettii, six with three unclassified genotypes, and one with B. burgdorferi sensu stricto. One serum sample (2%) from HREC was positive for a relapsing-fever group spirochete that had a 16S rRNA sequence homology of 99% with the C053 type strain of B. coriaceae. Spirochetes undetermined to geno-species were detected in thick-blood drops prepared from three (8%) of 36 deer from the HREC by direct immunofluorescence. Adults of the hippoboscid flies Lipoptena depressa (n=73) and Neolipoptena ferrisi (n=24), the Pacific Coast tick (Dermacentor occidentalis) (n=22), and the western black-legged tick (Ixodes pacificus) (n=1) that had been removed from deer from both study areas in 2002 were PCR test negative for borreliae. The occurrence of diverse borreliae in deer from northern California confounds and, consequently, reduces the utility of borrelial serosurveys for detecting specific genospecies, unless they are complemented by more specific assays (e.g., immunoblotting, PCR/sequencing analysis).

PMID: 15827217 [PubMed - indexed for MEDLINE]
www.ncbi.nlm.nih.gov/pubmed/15827217?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlusDrugs1

Determination of novel Borrelia genospecies in Swedish Ixodes ricinus ticks.
Fraenkel CJ, Garpmo U, Berglund J.

Department of Infectious Diseases, Blekinge Hospital, S-371 85 Karlskrona, Sweden. [e-mail]

A total of 301 adult questing Ixodes ricinus ticks were collected at 15 different locations along the south and east coasts of Sweden to determine the Borrelia genospecies diversity. Thirty-two ticks (11%) were found to be positive by nested PCR with Borrelia burgdorferi sensu lato-specific primers. Species determination was based on partial sequencing of the 16S rRNA gene and the flagellin gene. Five different Borrelia species were found. The nucleotide sequence of the Borrelia DNA found in two ticks differed extensively from the nucleotide sequences of the Borrelia DNA found in the other ticks, and analysis revealed that they were closely related to the relapsing fever borrelia species Borrelia miyamotoi. This is the first report of a B. miyamotoi-like borrelia in I. ricinus and in Europe. Moreover, the Borrelia DNA of two ticks (6%) clustered within the B. valaisiana complex. B. valaisiana has not previously been reported in Sweden. B. afzelii DNA was found in 14 ticks (44%), and B. garinii DNA was found in 10 ticks (31%). B. burgdorferi sensu stricto DNA was found in four ticks (13%). We conclude that all of the known human-pathogenic species (B. garinii, B. afzelii, and B. burgdorferi sensu stricto) and B. valaisiana found elsewhere in Europe are also present in the Swedish host-seeking tick population and that a B. miyamotoi-like Borrelia species seems to be present in I. ricinus ticks in Europe.

PMID: 12202571 [PubMed - indexed for MEDLINE]
www.ncbi.nlm.nih.gov/pubmed/12202571?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlusDrugs1

Third Borrelia species in white-footed mice:
www.cdc.gov/ncidod/EID/vol11no07/04-1355.htm

Borrelia sinica sp. nov., a Lyme disease-related Borrelia species isolated in China:
ijs.sgmjournals.org/cgi/content/abstract/51/5/1817

eMedicine - Tick-borne diseases, relapsing fever:
www.emedicine.com/emerg/topic590.htm

Wikipedia: en.wikipedia.org/wiki/Borrelia

[LymeEnigma]

It seems to me that there are numerous Borrelia species capable of causing varying degrees of illness in human beings, and by classifying many of these as either "Lyme" or "relapsing fever" we lose countless patients in the cracks.

I think about my ELISA and Western blot. I had a lot positive ELISA (1.16, and my twin sis tested at .90), and the Western blot bands that came up were:

IgG
23-25 IND
30 ++
39 IND
41 IND
66 +
83-93 IND

IgM
30 ++
31 IND
34 +
39 +
41 +

My Igenex IgM Western blot was "Igenex positive" yet "CDC negative." Might more than simple test unreliability be responsible for this? I think so. Why are HIV and syphilis ELISA titers considered reliable, and yet the Lyme titer is accepted as unreliable because of the spirochete's evasive nature and what it does to one's immune system? Yeah, Bb is very sophisticated for a pathogen, but is it really that hard to test for?

I honestly believe that those who are presenting with more severe of disease simply have a strain of Borrelia that science (or your typical GP) has not delineated from Bb, and that many chronic patients (probably all of us who are current posters here) are suffering from something worse than Lyme, a type of (or more than one) relapsing fever that eludes Lyme blood tests (by causing borderline or low-positive ELISAs and "negative" Western blots) because the antibody response is similar enough, yet not similar enough....

I'm going to start a new thread.

[LymeEnigma]

Relapsing Fever–Like Spirochetes Infecting European Vector Tick of Lyme Disease Agent:

Abstract: To determine whether relapsing fever–like spirochetes associated with hard ticks may infect Ixodes ricinus ticks in central Europe, we screened questing ticks for 16S rDNA similar to that of Asian and American relapsing fever–like spirochetes. We compared the prevalence of these spirochetes to that of Lyme disease spirochetes transmitted by the same vector. Relapsing fever-like spirochetes infect 3.5% of questing vector ticks in our three central European sites near the Rhein Valley. These spirochetes differ genetically from their American and Asian analogs while being relatively homogeneous in the region we sampled. The Lyme disease genospecies most commonly detected in central Europe are distributed broadly, whereas those that are less frequently found appear to be place-specific. The absence of co-infected ticks suggests that relapsing fever–like and Lyme disease spirochetes may not share hosts. Exposure risk for relapsing fever–like spirochetes is similar to that of certain Lyme disease genospecies. Although many persons may be bitten by ticks infected by relapsing fever–like spirochetes, health implications remain unknown.

Full text: www.cdc.gov/ncidod/EiD/vol9no6/02-0459.htm

[LymeEnigma]

Vector Interactions and Molecular Adaptations of Lyme Disease and Relapsing Fever Spirochetes Associated with Transmission by Ticks:

Abstract: Pathogenic spirochetes in the genus Borrelia are transmitted primarily by two families of ticks. The Lyme disease spirochete, Borrelia burgdorferi, is transmitted by the slow-feeding ixodid tick Ixodes scapularis, whereas the relapsing fever spirochete, B. hermsii, is transmitted by Ornithodoros hermsi, a fast-feeding argasid tick. Lyme disease spirochetes are generally restricted to the midgut in unfed I. scapularis. When nymphal ticks feed, the bacteria pass through the hemocoel to the salivary glands and are transmitted to a new host in the saliva after 2 days. Relapsing fever spirochetes infect the midgut in unfed O. hermsi but persist in other sites including the salivary glands. Thus, relapsing fever spirochetes are efficiently transmitted in saliva by these fast-feeding ticks within minutes of their attachment to a mammalian host. We describe how B. burgdorferi and B. hermsii change their outer surface during their alternating infections in ticks and mammals, which in turn suggests biological functions for a few surface-exposed lipoproteins.

Full text: www.medscape.com/viewarticle/424731

[LymeEnigma]

Relapsing Fever in Texas:

In a previous publication we (1) showed that the serum of rats solidly hyperimmunized to Borrelia novyi contained lytic bodies for the Texas relapsing fever spirochete. The serum of rats similarly hyperimmunized to strains of the Texas spirochete was shown to be lytic for Borrelia novyi. Since this cytolytic property was not observed in these sera for other strains of relapsing fever spirochetes, Borrelia kochi, Borrelia duttoni, and Borrelia obermeieri, we concluded that the Texas relapsing fever spirochete is closely related to, if not identical with, Borrelia novyi.

Brumpt (2) has recently shown that a strict specificity exists between the vector of relapsing fever in Texas, O. turicata, and the spirochete causing the disease. He found that this particular tick did not transmit other known strains of relapsing fever spirochetes, and, for that matter, that there was a similar degree of specificity between other vectors and spirochetes as they occur in different localities.

www.ajtmh.org/cgi/content/abstract/s1-14/2/159