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''Borrelia afzelii''<br />
''Borrelia afzelii''<br />
''Borrelia anserina''<br />
''Borrelia anserina''<br />
''Borrelia burgdorferi''<br />
''[[Borrelia burgdorferi]]''<br />
''Borrelia garinii''<br />
''Borrelia garinii''<br />
''Borrelia hermsii''<br />
''Borrelia hermsii''<br />
''Borrelia recurrentis''<br />
''[[Borrelia recurrentis]]''<br />
''Borrelia valaisiana''<br />
''Borrelia valaisiana''<br />
etc.<br/>
etc.<br/>
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{{Seealso|Lyme disease}}
{{Seealso|Lyme disease}}
{{Seealso|Relapsing fever}}
{{Seealso|Relapsing fever}}
{{SI}}
{{CMG}}
{{CMG}}


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Of the 37 known species of ''Borrelia'', 12 of these species are known to cause [[Lyme disease]] or borreliosis and are transmitted by ticks. The major ''Borrelia'' species causing Lyme disease are ''[[Borrelia burgdorferi]]'', ''Borrelia afzelii'', ''Borrelia garinii'' and ''Borrelia valaisiana''.
Of the 37 known species of ''Borrelia'', 12 of these species are known to cause [[Lyme disease]] or borreliosis and are transmitted by ticks. The major ''Borrelia'' species causing Lyme disease are ''[[Borrelia burgdorferi]]'', ''Borrelia afzelii'', ''Borrelia garinii'' and ''Borrelia valaisiana''.


==Species and Strains==
Until recently it was thought that only three genospecies caused Lyme disease (borreliosis): ''B. burgdorferi'' sensu stricto ( the predominant species in North America, but also present in Europe); ''B. afzelii''; and ''B. garinii'' (both predominant in Eurasia). To date the complete [[genome]] of ''B. burgdorferi'' sensu stricto strain B31, B. afzelii strain PKo and B. garinii strain PBi is known. ''B. burgdorferi'' strain B31 was derived by limited dilutional cloning from the original Lyme-disease tick isolate derived by Alan Barbour. There are over 300 species or strains of Borrelia world wide with apx 100 in the U.S. and it is unknown how many cause lyme like sickness, but many of them may.
At present, [[diagnostic]] tests are based only on ''B. burgdorferi'' sensu stricto (the only species used in the U.S.), ''B. afzelii'', and ''B. garinii''.
===Emerging Genospecies===
* ''B. valaisiana'' was identified as a genomic species from Strain VS116, and named B. valaisiana in 1997.<ref>{{cite journal |author=Wang G, van Dam AP, Le Fleche A, ''et al'' |title=Genetic and phenotypic analysis of Borrelia valaisiana sp. nov. (Borrelia genomic groups VS116 and M19) |journal=Int. J. Syst. Bacteriol. |volume=47 |issue=4 |pages=926-32 |year=1997 |pmid=9336888 |doi=}}</ref> It was later detected by [[Polymerase chain reaction]] (PCR) in human [[cerebral spinal fluid]] (CSF) in Greece.<ref name="Diza">{{cite journal |author=Diza E, Papa A, Vezyri E, Tsounis S, Milonas I, Antoniadis A |title=Borrelia valaisiana in cerebrospinal fluid |journal=Emerging Infect. Dis. |volume=10 |issue=9 |pages=1692-3 |year=2004 |pmid=15503409 |url=http://www.cdc.gov/ncidod/EID/vol10no9/03-0439.htm}}</ref> ''B. valaisiana'' has been isolated throughout Europe, as well east Asia.<ref>{{cite journal |author=Masuzawa T |title=Terrestrial distribution of the Lyme borreliosis agent Borrelia burgdorferi sensu lato in East Asia |journal=Jpn. J. Infect. Dis. |volume=57 |issue=6 |pages=229-35 |year=2004 |pmid=15623946 |doi=}}</ref>
Newly discovered genospecies have also been found to cause disease in humans:
*''B. lusitaniae'' <ref name="Collares">{{cite journal | author=Collares-Pereira M, Couceiro S, Franca I, Kurtenbach K, Schafer SM, Vitorino L, Goncalves L, Baptista S, Vieira ML, Cunha C | title=First isolation of Borrelia lusitaniae from a human patient | journal=J Clin Microbiol | year=2004 | pages=1316-8 | volume=42 | issue=3 | id=PMID 15004107 | url=http://jcm.asm.org/cgi/reprint/42/3/1316.pdf | format=PDF}}</ref> in Europe (especially Portugal), North Africa and Asia.
*''B. bissettii'' <ref name="Postic">{{cite journal | author=Postic D, Ras NM, Lane RS, Hendson M, Baranton G | title=Expanded diversity among Californian borrelia isolates and description of Borrelia bissettii sp. nov. (formerly Borrelia group DN127) | journal=J Clin Microbiol | year=1998 | pages=3497-504 | volume=36 | issue=12 | id=PMID 9817861 | url=http://jcm.asm.org/cgi/reprint/36/12/3497.pdf | format=PDF}}</ref><ref name="Maraspin">{{cite journal | author=Maraspin V, Cimperman J, Lotric-Furlan S, Ruzic-Sabljic E, Jurca T, Picken RN, Strle F | title=Solitary borrelial lymphocytoma in adult patients | journal=Wien Klin Wochenschr | year=2002 | pages=515-23 | volume=114 | issue=13-14 | id=PMID 12422593}}</ref> in the U.S. and Europe.
*''B. spielmanii'' <ref name="Richter">{{cite journal | author=Richter D, Postic D, Sertour N, Livey I, Matuschka FR, Baranton G | title=Delineation of Borrelia burgdorferi sensu lato species by multilocus sequence analysis and confirmation of the delineation of Borrelia spielmanii sp. nov | journal=Int J Syst Evol Microbiol | year=2006 | pages=873-81 | volume=56 | issue=Pt 4 | id=PMID 16585709}}</ref><ref name="Foldvari">{{cite journal | author=Foldvari G, Farkas R, Lakos A | title=Borrelia spielmanii erythema migrans, Hungary | journal=Emerg Infect Dis | year=2005 | pages=1794-5 | volume=11 | issue=11 | id=PMID 16422006 | url=http://www.cdc.gov/ncidod/EID/vol11no11/05-0542.htm}}</ref> in Europe.
Additional ''B. burgdorferi'' sensu lato genospecies suspected of causing illness, but not confirmed by culture, include B. japonica, B. tanukii and B. turdae (Japan); B. sinica (China); and ''B. andersonii'' (U.S.). Some of these species are carried by ticks not currently recognized as carriers of Lyme disease.
The ''B. miyamotoi'' spirochete, related to the [[relapsing fever]] group of spirochetes, is also suspected of causing illness in Japan. Spirochetes similar to B. miyamotoi have recently been found in both I. ricinus ticks in Sweden and I. scapularis ticks in the U.S.<!--
  --><ref name="Scoles">{{cite journal | author=Scoles GA, Papero M, Beati L, Fish D | title=A relapsing fever group spirochete transmitted by Ixodes scapularis ticks | journal=Vector Borne Zoonotic Dis | year=2001 | pages=21-34 | volume=1 | issue=1 | id=PMID 12653133}}</ref><!--
  --><ref name="Bunikis-b">{{cite journal | author=Bunikis J, Tsao J, Garpmo U, Berglund J, Fish D, Barbour AG | title=Typing of Borrelia relapsing fever group strains | journal=Emerg Infect Dis | year=2004 | pages=1661-4 | volume=10 | issue=9 | id=PMID 15498172}}</ref>
===B. lonestari===
Apart from this group of closely related genospecies, additional Borrelia species of interest include B. lonestari, a spirochete recently detected in the Amblyomma americanum tick (Lone Star tick) in the U.S.<!--
  --><ref name="Varela">{{cite journal | author=Varela AS, Luttrell MP, Howerth EW, Moore VA, Davidson WR, Stallknecht DE, Little SE | title=First culture isolation of Borrelia lonestari, putative agent of southern tick-associated rash illness | journal=J Clin Microbiol | year=2004 | pages=1163-9 | volume=42 | issue=3 | id=PMID 15004069 | url=http://jcm.asm.org/cgi/reprint/42/3/1163.pdf | format=PDF}}</ref><!--
--> ''B. lonestari'' is suspected of causing STARI (Southern Tick-Associated Rash Illness), also known as Masters disease in honor of its discoverer Ed Masters. The illness follows a Lone Star tick bite and clinically resembles Lyme disease, but sufferers usually test negative for Lyme.<!--
  --><ref name="Masters">{{cite journal | author=Masters E, Granter S, Duray P, Cordes P | title=Physician-diagnosed erythema migrans and erythema migrans-like rashes following Lone Star tick bites | journal=Arch Dermatol | year=1998 | pages=955-60 | volume=134 | issue=8 | id=PMID 9722725}}</ref>There is currently no diagnostic test available for STARI/Masters, and no official treatment protocol, though antibiotics are generally prescribed.
==Relapsing fever==
==Relapsing fever==
{{Main|Relapsing fever}}
{{Main|Relapsing fever}}


Other ''Borrelia'' species cause [[relapsing fever]] such as ''Borrelia recurrentis'', caused by the human body louse. No animal reservoir of ''B. recurrentis'' exists. Lice that feed on infected humans acquire the ''Borrelia'' organisms that then multiply in the gut of the louse. When an infected louse feeds on an uninfected human, the organism gains access when the victim crushes the louse or scratches the area where the louse is feeding. ''B. recurrentis'' infects the person via [[mucous membranes]] and then invades the bloodstream.  
Other ''Borrelia'' species cause [[relapsing fever]] such as ''[[Borrelia recurrentis]]'', caused by the human body louse. No animal reservoir of ''B. recurrentis'' exists. Lice that feed on infected humans acquire the ''Borrelia'' organisms that then multiply in the gut of the louse. When an infected louse feeds on an uninfected human, the organism gains access when the victim crushes the louse or scratches the area where the louse is feeding. ''B. recurrentis'' infects the person via [[mucous membranes]] and then invades the bloodstream.  


Other tick-borne relapsing infections are acquired from other species, such as ''Borrelia hermsii'' or ''Borrelia Parkeri'', which can be spread from rodents, and serve as a reservoir for the infection, via a tick vector. ''Borelia hermsii'' and ''Borrelia recurrentis'' cause very similar diseases although the disease associated with ''Borrelia hermsii'' has more relapses and is responsible for more fatalities, while the disease caused by ''B. recurrentis'' has longer febrile and afebrile intervals and a longer incubation period.
Other tick-borne relapsing infections are acquired from other species, such as ''Borrelia hermsii'' or ''Borrelia Parkeri'', which can be spread from rodents, and serve as a reservoir for the infection, via a tick vector. ''Borelia hermsii'' and ''Borrelia recurrentis'' cause very similar diseases although the disease associated with ''Borrelia hermsii'' has more relapses and is responsible for more fatalities, while the disease caused by ''B. recurrentis'' has longer febrile and afebrile intervals and a longer incubation period.
Line 57: Line 85:


</gallery>
</gallery>
==Treatment==
===Antimicrobial Regimen===
* Tick-Borne Relapsing Fever <ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
:* Preferred regimen: [[Doxycycline]] 100 mg PO twice daily for 5-10 days
:* Alternative regimen: [[Erythromycin]] 500 mg PO four times a day for 5-10 days
:* NOTE: If meningitis/encephalitis present, use [[Ceftriaxone]] 2 g IV q12h for 14 days
* Louse-Borne Relapsing Fever
:* Preferred regimen: single dose [[Tetracycline]] 500 mg PO
:* Alternative regimen: single dose [[Erythromycin]] 500 mg PO
* Lyme disease
:* Early Lyme Disease
::* Erythema migrans
:::* Preferred regimen: [[Doxycycline]] 100 mg twice per day for 10-21 days {{or}} [[Amoxicillin]] 500 mg 3 times per day for 14-21 days {{or}} [[Cefuroxime axetil]] 500 mg twice per day for 14-21 days
::* Lyme meningitis and other manifestations of early neurologic Lyme disease
:::* Preferred regimen:
::* Lyme carditis
:::* Preferred regimen:
::* Borrelial lymphocytoma
:::* Preferred regimen:
:* Late Lyme Disease
::* Lyme arthritis
:::* Preferred regimen:
::* Late neurologic Lyme disease
:::* Preferred regimen:
::* Acrodermatitis chronica atrophicans
:::* Preferred regimen:
::* Coinfection
:::* Preferred regimen:
:* Post–Lyme Disease Syndromes
:::* Preferred regimen:


==External links==
==External links==

Latest revision as of 19:09, 17 August 2015

Borrelia
Scientific classification
Kingdom: Bacteria
Phylum: Spirochaetes
Class: Spirochaetes
Order: Spirochaetales
Family: Spirochaetaceae
Genus: Borrelia
Species

Borrelia afzelii
Borrelia anserina
Borrelia burgdorferi
Borrelia garinii
Borrelia hermsii
Borrelia recurrentis
Borrelia valaisiana
etc.

Template:Seealso Template:Seealso Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Borrelia is a genus of bacteria of the spirochete class. It is a zoonotic, vector-borne disease transmitted primarily by ticks and some by lice, depending on the species. There are 37 known species of Borrelia.

Borreliosis (Lyme disease)

Main article: Lyme disease

Of the 37 known species of Borrelia, 12 of these species are known to cause Lyme disease or borreliosis and are transmitted by ticks. The major Borrelia species causing Lyme disease are Borrelia burgdorferi, Borrelia afzelii, Borrelia garinii and Borrelia valaisiana.

Species and Strains

Until recently it was thought that only three genospecies caused Lyme disease (borreliosis): B. burgdorferi sensu stricto ( the predominant species in North America, but also present in Europe); B. afzelii; and B. garinii (both predominant in Eurasia). To date the complete genome of B. burgdorferi sensu stricto strain B31, B. afzelii strain PKo and B. garinii strain PBi is known. B. burgdorferi strain B31 was derived by limited dilutional cloning from the original Lyme-disease tick isolate derived by Alan Barbour. There are over 300 species or strains of Borrelia world wide with apx 100 in the U.S. and it is unknown how many cause lyme like sickness, but many of them may.

At present, diagnostic tests are based only on B. burgdorferi sensu stricto (the only species used in the U.S.), B. afzelii, and B. garinii.

Emerging Genospecies

  • B. valaisiana was identified as a genomic species from Strain VS116, and named B. valaisiana in 1997.[1] It was later detected by Polymerase chain reaction (PCR) in human cerebral spinal fluid (CSF) in Greece.[2] B. valaisiana has been isolated throughout Europe, as well east Asia.[3]

Newly discovered genospecies have also been found to cause disease in humans:

  • B. lusitaniae [4] in Europe (especially Portugal), North Africa and Asia.
  • B. bissettii [5][6] in the U.S. and Europe.
  • B. spielmanii [7][8] in Europe.

Additional B. burgdorferi sensu lato genospecies suspected of causing illness, but not confirmed by culture, include B. japonica, B. tanukii and B. turdae (Japan); B. sinica (China); and B. andersonii (U.S.). Some of these species are carried by ticks not currently recognized as carriers of Lyme disease.

The B. miyamotoi spirochete, related to the relapsing fever group of spirochetes, is also suspected of causing illness in Japan. Spirochetes similar to B. miyamotoi have recently been found in both I. ricinus ticks in Sweden and I. scapularis ticks in the U.S.[9][10]

B. lonestari

Apart from this group of closely related genospecies, additional Borrelia species of interest include B. lonestari, a spirochete recently detected in the Amblyomma americanum tick (Lone Star tick) in the U.S.[11] B. lonestari is suspected of causing STARI (Southern Tick-Associated Rash Illness), also known as Masters disease in honor of its discoverer Ed Masters. The illness follows a Lone Star tick bite and clinically resembles Lyme disease, but sufferers usually test negative for Lyme.[12]There is currently no diagnostic test available for STARI/Masters, and no official treatment protocol, though antibiotics are generally prescribed.

Relapsing fever

Main article: Relapsing fever

Other Borrelia species cause relapsing fever such as Borrelia recurrentis, caused by the human body louse. No animal reservoir of B. recurrentis exists. Lice that feed on infected humans acquire the Borrelia organisms that then multiply in the gut of the louse. When an infected louse feeds on an uninfected human, the organism gains access when the victim crushes the louse or scratches the area where the louse is feeding. B. recurrentis infects the person via mucous membranes and then invades the bloodstream.

Other tick-borne relapsing infections are acquired from other species, such as Borrelia hermsii or Borrelia Parkeri, which can be spread from rodents, and serve as a reservoir for the infection, via a tick vector. Borelia hermsii and Borrelia recurrentis cause very similar diseases although the disease associated with Borrelia hermsii has more relapses and is responsible for more fatalities, while the disease caused by B. recurrentis has longer febrile and afebrile intervals and a longer incubation period.

Gallery

External links

Template:WH Template:WS

References

  1. ↑ Wang G, van Dam AP, Le Fleche A; et al. (1997). "Genetic and phenotypic analysis of Borrelia valaisiana sp. nov. (Borrelia genomic groups VS116 and M19)". Int. J. Syst. Bacteriol. 47 (4): 926–32. PMID 9336888.
  2. ↑ Diza E, Papa A, Vezyri E, Tsounis S, Milonas I, Antoniadis A (2004). "Borrelia valaisiana in cerebrospinal fluid". Emerging Infect. Dis. 10 (9): 1692–3. PMID 15503409.
  3. ↑ Masuzawa T (2004). "Terrestrial distribution of the Lyme borreliosis agent Borrelia burgdorferi sensu lato in East Asia". Jpn. J. Infect. Dis. 57 (6): 229–35. PMID 15623946.
  4. ↑ Collares-Pereira M, Couceiro S, Franca I, Kurtenbach K, Schafer SM, Vitorino L, Goncalves L, Baptista S, Vieira ML, Cunha C (2004). "First isolation of Borrelia lusitaniae from a human patient" (PDF). J Clin Microbiol. 42 (3): 1316–8. PMID 15004107.
  5. ↑ Postic D, Ras NM, Lane RS, Hendson M, Baranton G (1998). "Expanded diversity among Californian borrelia isolates and description of Borrelia bissettii sp. nov. (formerly Borrelia group DN127)" (PDF). J Clin Microbiol. 36 (12): 3497–504. PMID 9817861.
  6. ↑ Maraspin V, Cimperman J, Lotric-Furlan S, Ruzic-Sabljic E, Jurca T, Picken RN, Strle F (2002). "Solitary borrelial lymphocytoma in adult patients". Wien Klin Wochenschr. 114 (13–14): 515–23. PMID 12422593.
  7. ↑ Richter D, Postic D, Sertour N, Livey I, Matuschka FR, Baranton G (2006). "Delineation of Borrelia burgdorferi sensu lato species by multilocus sequence analysis and confirmation of the delineation of Borrelia spielmanii sp. nov". Int J Syst Evol Microbiol. 56 (Pt 4): 873–81. PMID 16585709.
  8. ↑ Foldvari G, Farkas R, Lakos A (2005). "Borrelia spielmanii erythema migrans, Hungary". Emerg Infect Dis. 11 (11): 1794–5. PMID 16422006.
  9. ↑ Scoles GA, Papero M, Beati L, Fish D (2001). "A relapsing fever group spirochete transmitted by Ixodes scapularis ticks". Vector Borne Zoonotic Dis. 1 (1): 21–34. PMID 12653133.
  10. ↑ Bunikis J, Tsao J, Garpmo U, Berglund J, Fish D, Barbour AG (2004). "Typing of Borrelia relapsing fever group strains". Emerg Infect Dis. 10 (9): 1661–4. PMID 15498172.
  11. ↑ Varela AS, Luttrell MP, Howerth EW, Moore VA, Davidson WR, Stallknecht DE, Little SE (2004). "First culture isolation of Borrelia lonestari, putative agent of southern tick-associated rash illness" (PDF). J Clin Microbiol. 42 (3): 1163–9. PMID 15004069.
  12. ↑ Masters E, Granter S, Duray P, Cordes P (1998). "Physician-diagnosed erythema migrans and erythema migrans-like rashes following Lone Star tick bites". Arch Dermatol. 134 (8): 955–60. PMID 9722725.
  13. ↑ 13.0 13.1 13.2 13.3 13.4 13.5 "Public Health Image Library (PHIL)".
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