Borrelia burgdorferi: Difference between revisions

	Lyme disease Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Epidemiology and Demographics
Causes
Differentiating Lyme disease from other Diseases
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
History and Symptoms
Physical Examination
Laboratory Findings
ECG
X-ray
CT scan
MRI
Ultrasound
Other Imaging Findings
Other Diagnostic Sudies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Future or Investigational Therapies
Case Studies
Case #1
Borrelia burgdorferi On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Borrelia burgdorferi All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Borrelia burgdorferi
CDC on Borrelia burgdorferi
Borrelia burgdorferi in the news
Blogs on Borrelia burgdorferi
Directions to Hospitals Treating Lyme disease
Risk calculators and risk factors for Borrelia burgdorferi

Borrelia burgdorferi
Scientific classification
Kingdom:	Bacteria;
Phylum:	Spirochaetes;
Class:	Spirochaetes;
Order:	Spirochaetales;
Genus:	Borrelia;
Species:	B. burgdorferi;
Binomial name
	Borrelia burgdorferi;

VisualWikitext

Revision as of 19:12, 17 August 2015

This page is about microbiologic aspects of the organism(s). For clinical aspects of the disease, see Lyme disease.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2] Template:Seealso

Overview

Borrelia burgdorferi is species of bacteria of the spirochete class of the genus Borrelia. B. burgdorferi is predominant in North America, but also exists in Europe, and is the agent of Lyme disease. It is a zoonotic, vector-borne disease transmitted by ticks and is named after the researcher Willy Burgdorfer who first isolated the bacterium in 1982. B. burgdorferi is one of the few pathogenic bacteria that can survive without iron, having replaced all of its iron-sulphur cluster enzymes with enzymes that use manganese, thus avoiding the problem many pathogenic bacteria face in acquiring iron. B. burgdorferi infections have been linked to non-Hodgkin lymphomas.^[1]

Organism

*Borrelia burgdorferi* the causative agent of Lyme disease (borreliosis). Magnified 400 times.

Lyme disease, or Lyme borreliosis, is caused by Gram negative spirochetal bacteria from the genus Borrelia, which has at least 37 known species, 12 of which are Lyme related, and an unknown number of genomic strains. Borrelia species known to cause Lyme disease are collectively known as Borrelia burgdorferi sensu lato.

Borrelia are microaerophillic and slow-growing—the primary reason for the long delays when diagnosing Lyme disease—and have been found to have greater strain diversity than previously estimated.^[2] The strains differ in clinical symptoms and/or presentation as well as geographic distribution.^[3]

Except for Borrelia recurrentis (which causes louse-borne relapsing fever and is transmitted by the human body louse), all known species are believed to be transmitted by ticks.^[4]

Structure and growth

B. burgdorferi is a highly specialized, motile, two-membrane, spiral-shaped spirochete ranging from about 9 to 32 micrometers in length. It is often described as gram-negative and has an outer membrane with lipopolysaccharide (LPS), though it stains only weakly in the Gram stain. B. burgdorferi is a microaerophilic organism, requiring little oxygen to survive. It lives primarily as an extracellular pathogen, although it can also hide intracellularly (see Mechanisms of persistence section).

Like other spirochetes such as T. pallidum (the agent of syphilis), B. burgdorferi has an axial filament composed of flagella which run lengthways between its cell wall and outer membrane. This structure allows the spirochete to move efficiently in corkscrew fashion through viscous media, such as connective tissue. As a result, B. burgdorferi can disseminate throughout the body within days to weeks of infection, penetrating deeply into tissue where the immune system and antibiotics may not be able to eradicate the infection.

B. burgdorferi is very slow growing, with a doubling time of 12-18 hours^[5] (in contrast to pathogens such as Streptococcus and Staphylococcus, which have a doubling time of 20-30 minutes). Since most antibiotics kill bacteria only when they are dividing, this longer doubling time necessitates the use of relatively longer treatment courses for Lyme disease. Antibiotics are most effective during the growth phase, which for B. burgdorferi occurs in four-week cycles.

Outer surface proteins

The outer membrane of Borrelia burgdorferi is composed of various unique outer surface proteins (Osp) that have been characterized (OspA through OspF). They are presumed to play a role in virulence.

OspA and OspB are by far the most abundant outer surface proteins.

The OspA and OspB genes encode the major outer membrane proteins of the B burgdorferi. The two Osp proteins show a high degree of sequence similarity, indicating a recent evolutionary event. Molecular analysis and sequence comparison of OspA and OspB with other proteins has revealed similarity to the signal peptides of prokaryotic lipoproteins.^[6]Virtually all spirochetes in the midgut of an unfed nymph tick express OspA.

OspC is an antigen-detection of its presence by the host organism and can stimulate an immune response. While each individual bacterial cell contains just one copy of the gene encoding OspC, populations of B. burgdorferi have shown high levels of variation among individuals in the gene sequence for OspC.^[7] OspC is likely to play a role in transmission from vector to host, since it has been observed that the protein is only expressed in the presence of mammalian blood or tissue.^[8]

The functions of OspD are unknown.

OspE and OspF are structurally arranged in tandem as one transcriptional unit under the control of a common promoter.^[9]

In transmission to the mammaliam host, when the nymphal tick begins to feed, and the spirochetes in the midgut begin to multiply rapidly, most spirochetes cease expressing OspA on their surface. Simultaneous with the disappearance of OspA, the spirochete population in the midgut begins to express a OspC. Upregulation of OspC begins during the first day of feeding and peaks 48 hours after attachment.^[10]

Gallery

Histopathology showing Borrelia burgdorferi spirochetes in Lyme disease. From Public Health Image Library (PHIL). ^[11]
White-footed mouse, Peromyscus leucopus, which is a host of ticks thatare known to carry the bacteria, Borrelia burgdorferi, responsible for Lyme disease. From Public Health Image Library (PHIL). ^[11]
“Corkscrew-shaped” bacteria known as Borrelia burgdorferi, which is the pathogen responsible for causing Lyme disease (400x mag). From Public Health Image Library (PHIL). ^[11]
Facial palsy caused by an infection by the bacterial spirochete Borrelia burgdorferi, and was subsequently diagnosed with Lyme disease. From Public Health Image Library (PHIL). ^[11]
Borrelia burgdorferi bacteria derived from a pure culture. From Public Health Image Library (PHIL). ^[11]
Borrelia burgdorferi bacteria derived from a pure culture. From Public Health Image Library (PHIL). ^[11]
Borrelia burgdorferi bacteria derived from a pure culture. From Public Health Image Library (PHIL). ^[11]
Borrelia burgdorferi bacteria derived from a pure culture. From Public Health Image Library (PHIL). ^[11]
Borrelia burgdorferi bacteria derived from a pure culture.From Public Health Image Library (PHIL). ^[11]
Borrelia burgdorferi bacteria derived from a pure culture. From Public Health Image Library (PHIL). ^[11]
Borrelia burgdorferi bacteria derived from a pure culture. From Public Health Image Library (PHIL). ^[11]
Dorsal view of an adult female western blacklegged tick, whichs transmit Borrelia burgdorferi (agent of Lyme disease). From Public Health Image Library (PHIL). ^[11]
Dorsal view of an adult female western blacklegged tick, whichs transmit Borrelia burgdorferi (agent of Lyme disease). From Public Health Image Library (PHIL). ^[11]
Dorsal view of engorged female tick, extracted from the skin of a pet cat (26X mag). From Public Health Image Library (PHIL). ^[11]
Dorsal view of engorged female tick in the process of obtaining its blood meal (207X magnification). From Public Health Image Library (PHIL). ^[11]
Scanning electron micrographic (SEM) image depicts dorsal view of engorged female tick (201X magnification). From Public Health Image Library (PHIL). ^[11]
Photomicrographic montage using the immunofluorescent antibody technique (IFA) used to produce this B. burgdorferi multicolored image. From Public Health Image Library (PHIL). ^[11]
Lateral view of female deer tick, Ixodes scapularis, with its abdomen engorged with a host blood meal.From Public Health Image Library (PHIL). ^[11]
Peripheral blood from a newborn child indicates the presence of numerous Borrelia hermsii spirochetes (arrows), consistent with a tickborne relapsing fever (TBRF) infection. From Public Health Image Library (PHIL). ^[11]
Dorsal view of a soft tick, Ornithodoros hermsi, which is a known vector for the disease tick-borne relapsing fever (TBRF) (6.5x mag). From Public Health Image Library (PHIL). ^[11]
Deer tick, Ixodes scapularis. From Public Health Image Library (PHIL). ^[11]
Borrelia burgdorferi bacteria derived from a pure culture. From Public Health Image Library (PHIL). ^[11]
Borrelia burgdorferi bacteria derived from a pure culture. From Public Health Image Library (PHIL). ^[11]
Borrelia burgdorferi bacteria derived from a pure culture.From Public Health Image Library (PHIL). ^[11]
Borrelia burgdorferi bacteria derived from a pure culture. From Public Health Image Library (PHIL). ^[11]
Borrelia burgdorferi bacteria derived from a pure culture. From Public Health Image Library (PHIL). ^[11]
Borrelia burgdorferi bacteria derived from a pure culture. From Public Health Image Library (PHIL). ^[11]
Borrelia burgdorferi bacteria derived from a pure culture. From Public Health Image Library (PHIL). ^[11]
Dorsal view of engorged female tick in the process of obtaining its blood meal (201x mag). From Public Health Image Library (PHIL). ^[11]
Dorsal view of engorged female tick, extracted from the skin of a pet cat (26x mag). From Public Health Image Library (PHIL). ^[11]
Male Dermacentor sp. tick found upon a cat (95x mag). From Public Health Image Library (PHIL). ^[11]
Dorsal view of male Dermacentor sp. tick found on a cat (3043x mag). From Public Health Image Library (PHIL). ^[11]
Dorsal view of a female "lone star tick", Amblyomma americanum. From Public Health Image Library (PHIL). ^[11]
Anterior view of engorged female "lone star tick", Amblyomma americanum. From Public Health Image Library (PHIL). ^[11]
Ventral view of engorged female "lone star tick" Amblyomma americanum. From Public Health Image Library (PHIL). ^[11]
“Corkscrew-shaped” bacteria known as Borrelia burgdorferi, the pathogen responsible for causing Lyme disease (400x mag). From Public Health Image Library (PHIL). ^[11]
White-footed mouse, Peromyscus leucopus, which is a wild rodent reservoir host of ticks, which are known to carry the bacteria, Borrelia burgdorferi, responsible for Lyme disease. From Public Health Image Library (PHIL). ^[11]
This photograph of a whitetail deer, Odocoileus virginianus, was taken during a Lyme disease field investigation in 1993. From Public Health Image Library (PHIL). ^[11]
This is a dorsal view of the “soft tick” Carios kelleyi, formerly Ornithodoros kelleyi, or the “Bat Tick”. From Public Health Image Library (PHIL). ^[11]
This is a dorsal view of the “soft tick” Carios kelleyi, formerly Ornithodoros kelleyi, or the “Bat Tick”. From Public Health Image Library (PHIL). ^[11]
This is a female “Lone star tick”, Amblyomma americanum, and is found in the southeastern and midatlantic United States. From Public Health Image Library (PHIL). ^[11]
These "black-legged ticks", Ixodes scapularis, also referred to as I. dammini, are found on a wide rage of hosts including mammals, birds and reptiles.From Public Health Image Library (PHIL). ^[11]
Histopathology showing Borrelia burgdorferi spirochetes in Lyme disease. Dieterle silver stain.From Public Health Image Library (PHIL). ^[11]
“Corkscrew-shaped” bacteria known as Borrelia burgdorferi, which is the pathogen responsible for causing Lyme disease (400x mag). From Public Health Image Library (PHIL). ^[11]

References

↑ Guidoboni M, Ferreri AJ, Ponzoni M, Doglioni C, Dolcetti R (2006). "Infectious agents in mucosa-associated lymphoid tissue-type lymphomas: pathogenic role and therapeutic perspectives". Clinical lymphoma & myeloma. 6 (4): 289–300. PMID 16507206.
↑ Bunikis J, Garpmo U, Tsao J, Berglund J, Fish D, Barbour AG (2004). "Sequence typing reveals extensive strain diversity of the Lyme borreliosis agents Borrelia burgdorferi in North America and Borrelia afzelii in Europe" (PDF). Microbiology. 150 (Pt 6): 1741–55. PMID 15184561.
↑ Ryan KJ, Ray CG (editors) (2004). Sherris Medical Microbiology (4th ed. ed.). McGraw Hill. ISBN 0-8385-8529-9.
↑ Felsenfeld O (1971). Borrelia: Strains, Vectors, Human and Animal Borreliosis. St. Louis: Warren H. Green, Inc.
↑ Kelly, R. T. (1984). Genus IV. Borrelia Swellengrebel 1907, 582AL. In Bergey's Manual of Systematic Bacteriology, vol. 1, pp. 57–62. Edited by N. R. Krieg & J. G. Holt. Baltimore: Williams & Wilkins.
↑ Bergstrom S. , Bundoc V.G. , Barbour A.G. Molecular analysis of linear plasmid-encoded major surface proteins, OspA and OspB, of the Lyme disease spirochaete Borrelia burgdorferi. Mol. Microbiol. 3 479-486 1989
↑ Girschick, J. and Singh, S.E. Molecular survival strategies of the lyme disease spirochete Borrelia burgdorferi. Sep, 2004. The Lancet Infectious Diseases: Volume 4, Issue 9, September 2004, Pages 575-583.
↑ Fikrig, E. and Pal, U. Adaptation of Borrelia burgdorferi in the vector and vertebrate host. Microbes and Infection Volume 5, Issue 7, June 2003, Pages 659-666. PMID 12787742
↑ Lam TT, Nguyen TP, Montgomery RR, Kantor FS, Fikrig E, Flavell RA. Outer surface proteins E and F of Borrelia burgdorferi, the agent of Lyme disease. Infect Immun. 1994 Jan;62(1):290-8.
↑ Schwan TG, Piesman J. Temporal changes in outer surface proteins A and C of the Lyme disease-associated spirochete, Borrelia burgdorferi, during the chain of infection in ticks and mice. J Clin Microbiol 2000;38:382-8.
↑ ^11.00 ^11.01 ^11.02 ^11.03 ^11.04 ^11.05 ^11.06 ^11.07 ^11.08 ^11.09 ^11.10 ^11.11 ^11.12 ^11.13 ^11.14 ^11.15 ^11.16 ^11.17 ^11.18 ^11.19 ^11.20 ^11.21 ^11.22 ^11.23 ^11.24 ^11.25 ^11.26 ^11.27 ^11.28 ^11.29 ^11.30 ^11.31 ^11.32 ^11.33 ^11.34 ^11.35 ^11.36 ^11.37 ^11.38 ^11.39 ^11.40 ^11.41 ^11.42 ^11.43 "Public Health Image Library (PHIL)".

External Links

de:Wanderröte

Template:WS

[Guidoboni_2006-1] Guidoboni M, Ferreri AJ, Ponzoni M, Doglioni C, Dolcetti R (2006). "Infectious agents in mucosa-associated lymphoid tissue-type lymphomas: pathogenic role and therapeutic perspectives". Clinical lymphoma & myeloma. 6 (4): 289–300. PMID 16507206.

[Bunikis-a-2] Bunikis J, Garpmo U, Tsao J, Berglund J, Fish D, Barbour AG (2004). "Sequence typing reveals extensive strain diversity of the Lyme borreliosis agents Borrelia burgdorferi in North America and Borrelia afzelii in Europe" (PDF). Microbiology. 150 (Pt 6): 1741–55. PMID 15184561.

[Sherris-3] Ryan KJ, Ray CG (editors) (2004). Sherris Medical Microbiology (4th ed. ed.). McGraw Hill. ISBN 0-8385-8529-9.

[4] Felsenfeld O (1971). Borrelia: Strains, Vectors, Human and Animal Borreliosis. St. Louis: Warren H. Green, Inc.

[5] Kelly, R. T. (1984). Genus IV. Borrelia Swellengrebel 1907, 582AL. In Bergey's Manual of Systematic Bacteriology, vol. 1, pp. 57–62. Edited by N. R. Krieg & J. G. Holt. Baltimore: Williams & Wilkins.

[6] Bergstrom S. , Bundoc V.G. , Barbour A.G. Molecular analysis of linear plasmid-encoded major surface proteins, OspA and OspB, of the Lyme disease spirochaete Borrelia burgdorferi. Mol. Microbiol. 3 479-486 1989

[7] Girschick, J. and Singh, S.E. Molecular survival strategies of the lyme disease spirochete Borrelia burgdorferi. Sep, 2004. The Lancet Infectious Diseases: Volume 4, Issue 9, September 2004, Pages 575-583.

[Fikrig-8] Fikrig, E. and Pal, U. Adaptation of Borrelia burgdorferi in the vector and vertebrate host. Microbes and Infection Volume 5, Issue 7, June 2003, Pages 659-666. PMID 12787742

[9] Lam TT, Nguyen TP, Montgomery RR, Kantor FS, Fikrig E, Flavell RA. Outer surface proteins E and F of Borrelia burgdorferi, the agent of Lyme disease. Infect Immun. 1994 Jan;62(1):290-8.

[10] Schwan TG, Piesman J. Temporal changes in outer surface proteins A and C of the Lyme disease-associated spirochete, Borrelia burgdorferi, during the chain of infection in ticks and mice. J Clin Microbiol 2000;38:382-8.

[PHIL-11] 11.00 ^11.01 ^11.02 ^11.03 ^11.04 ^11.05 ^11.06 ^11.07 ^11.08 ^11.09 ^11.10 ^11.11 ^11.12 ^11.13 ^11.14 ^11.15 ^11.16 ^11.17 ^11.18 ^11.19 ^11.20 ^11.21 ^11.22 ^11.23 ^11.24 ^11.25 ^11.26 ^11.27 ^11.28 ^11.29 ^11.30 ^11.31 ^11.32 ^11.33 ^11.34 ^11.35 ^11.36 ^11.37 ^11.38 ^11.39 ^11.40 ^11.41 ^11.42 ^11.43 "Public Health Image Library (PHIL)".

[1]

[2]

[3]

[4]

[5]

[6]

[7]

[8]

[9]

[10]

[11]

@@ Line 29: / Line 29: @@
 Except for ''Borrelia recurrentis'' (which causes louse-borne [[relapsing fever]] and is transmitted by the human body louse), all known species are believed to be transmitted by ticks.<ref>{{cite book | author = Felsenfeld O |title = Borrelia: Strains, Vectors, Human and Animal Borreliosis| location = St. Louis | publisher = Warren H. Green, Inc | year = 1971}}</ref>
-==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.
 ==Structure and growth==