Lymphoreticular and Hematopoetic Infections 
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Borrelia miyamotoi DISEASE (BMD)

BMD is an emerging tick-borne disease occurring in July/August in the Northeastern United States. Cases of BMD were first reported in the summer of 2013. So far 53 cases have been positively identified.


Borrelia miyamotoi- BMD was first identified in Japan in 1995 and is distantly related to Borrelia burgdoferi. The first human cases of BMD were reported in 2011 in Russia. The bacterium has been detected in two species of ticks in the U.S. The black-legged or “deer” tick (Ixodes scapularis) and the western black-legged tick (Ixodes pacificus). These ticks are also transmit Lyme disease, anaplasmosis, and babesiosis.


Patients present with high fever, chills, marked headache, and myalgia or arthralgia. Elevated liver enzyme levels, neutropenia, and thrombocytopenia are common. This disease looks a lot like Anaplasmosis.


Diagnosis is made using PCR. However, the test is not routinely available in the U.S. An ELISA was recently developed to detect antibodies to this bacterium. However it is not commercially available.

Therapy and Prevention

The drug of choice for treating BMD is doxycycline. Amoxicillin and ceftriaxone are also effective in treating BMD. Infections can be prevented by limiting exposure to ticks. In persons exposed to tick-infested habitats, prompt, careful inspection and removal of crawling or attached ticks is an important method of preventing disease.

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Revised 06/22/15
©2015, Neal R. Chamberlain, Ph.D., All rights reserved

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