The Health Burden of A Recently Discovered Borrelia Spirochete

描述(申请人提供)：我们发现了一种新的螺旋体，可在实验室小鼠中引起持续感染，并广泛分布于全美莱姆病硬蜱媒介的野外种群中。初步的遗传和抗原分析表明，该菌属于与回归热螺旋体密切相关的一组成员，最初在日本被描述为宫本疏螺旋体。最近的调查提供了令人信服的证据，表明这种螺旋体在俄罗斯会导致人类疾病，在俄罗斯，感染宫本丝虫的硬蜱所占比例与美国东北部相似。其中一些患者经历了长期的、反复发作的疾病。关于这种新型螺旋体的遗传和抗原特征缺乏基本信息，诊断工具还没有开发出来用于临床。虽然目前只有几个人感染宫本杆菌的病例被确认，但我们怀疑，在其广泛的地理分布范围内，可能还有其他地方存在病例，特别是在莱姆病高度流行的美国东北部。因此，我们建议研究宫本螺旋体与其他疏螺旋体的抗原性关系，以改进诊断方法，并比较东北地区宫本螺旋体与伯氏疏螺旋体的感染频率和临床表现。迫切需要这种信息，因为在莱姆病流行地区，人类高度暴露于可能感染宫本杆菌的扁虱叮咬，而且无法用诊断莱姆病的相同实验室程序检测到感染。由于宫本杆菌属于螺旋体复发发热组，会持续出现反复发烧的症状，因此可能是由于宫本杆菌感染导致了莱姆病和慢性莱姆病的延长发作。

DESCRIPTION (provided by applicant): We have found a new Borrelia spirochete that causes persistent infection in laboratory mice and is widely distributed in field populations of Ixodes tick vectors of Lyme disease throughout the United States. Preliminary genetic and antigen analysis indicates that this organism is a member of a closely related group of relapsing fever spirochetes and was originally described as Borrelia miyamotoi in Japan. Recent investigations provide convincing evidence that this spirochete causes human disease in Russia where the percentages of B. miyamotoi-infected Ixodes ticks are similar to those in the northeastern United States. Some of these patients experienced prolonged, relapsing illness. Basic information is lacking regarding genetic and antigenic characteristics of this novel spirochete and diagnostic tools are not yet developed for clinical use. Although only a few human cases of infection with B. miyamotoi are currently recognized, we suspect that cases may exist elsewhere within its broad geographic distribution and particularly in the northeastern United States where Lyme disease is hyperendemic. Accordingly, we propose to investigate the antigenic relationship between B. miyamotoi and other Borrelia species in order to develop improved diagnostic methods and to compare the frequency and clinical manifestations of B. miyamotoi infection with those of Borrelia burgdorferi in the Northeast. Such information is urgently needed because of the high level of human exposure to bites from ticks potentially infected with B. miyamotoi in Lyme endemic regions and because infection cannot be detected with the same laboratory procedures used to diagnose Lyme disease. Because B. miyamotoi belongs to the relapsing fever group of spirochetes and causes persistent illness with relapsing fever symptoms, it is possible that some prolonged episodes of illness attributed to Lyme disease and designated as "chronic Lyme disease" are due to B. miyamotoi infection.