Borrelia mayonii Disease Information for Health Professionals

Borrelia mayonii disease is a bacterial illness most likely transmitted to humans by the blacklegged (deer) tick. The disease agent is closely related to the bacteria that causes Lyme disease. Human illness due to B. mayonii was first identified in a Minnesota resident in 2013. Since then, an average of 1-3 cases have been reported in Minnesota residents each year.

On this page:
Clinical presentation
Diagnostic tests
Treatment
Guidelines
Reporting

Clinical Presentation

While the spectrum of illness due to B. mayonii is still being described, common signs and symptoms that have been reported to date include an acute onset of fever, headache, myalgia, arthralgia, and rash. Similar to Lyme disease caused by B. burgdorferi, arthritis has also been reported as a later stage of infection in patients with illnesses due to B. mayonii. Laboratory abnormalities have also included lymphopenia, thrombocytopenia, and elevated hepatic transaminases.

Diagnostic tests

Currently, confirmation of a diagnosis relies on the use of polymerase chain reaction (PCR) tests that detect DNA from the organism. This assay is not widely available but can be ordered from Mayo Medical Laboratories. Patients with B. mayonii infection may develop a serologic response similar to that of patients infected with B. burgdorferi although more research is needed to determine how frequently this occurs. In some instances, spirochetes may also be seen on Giemsa-stained blood smear.

Treatment

Patients diagnosed with infection due to B. mayonii have been successfully treated with a 2-4 week course of doxycycline. Amoxicillin, ceftriaxone, and cefuroxime have also been used.

Guidelines

• CDC: Borrelia mayonii
  
  
• CDC: Tickborne Diseases of the United States: A Reference Manual for Health Care Providers
  CDC Handbook, designed as a way for health care providers to access information on tickborne diseases and tick identification. 
  
  
  
• IDSA: The Clinical Assessment, Treatment, and Prevention of Lyme Disease, Human Granulocytic Anaplasmosis, and Babesiosis
  Clinical Practice Guidelines by the Infectious Diseases Society of America.

Reporting

• Reporting Lyme Disease
  Minnesota Rules Governing Communicable Diseases require Lyme Disease (Borrelia burgdorferi, and other Borrelia spp.) to be reported to MDH within one working day.
  
  MDH staff also are available to provide clinical consultation regarding diagnosis and treatment of B. mayonii and other tickborne diseases. Call 651-201-5414 for a clinical consultation.