Restricted accessResearch articleFirst published online 2023-02
Investigation of a Symptomatic Tick Bite Patient Confirms Borrelia burgdorferi in Ixodes scapularis and White-Footed Mice in Ashe County,North Carolina
In June 2021, a traveler to Ashe County, North Carolina, was bitten by an Ixodes scapularis tick. The patient experienced axillary lymphadenopathy and an erythematous rash near the bite site. We confirmed Borrelia burgdorferi sensu stricto through PCR testing and DNA sequencing in the attached tick and later from mice trapped inside the cabin where the patient stayed.
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References
1.
AppersonCS, LevineJF, NicholsonWL. Geographic occurrence of Ixodes scapularis and Amblyomma americanum (Acari: Ixodidae) infesting white-tailed deer in North Carolina. J Wildl Dis, 1990; 26:550–553; doi: 10.7589/0090-3558-26.4.550
2.
BarbarinAM, SeagleSW, CreedeS. Notes from the Field: Four cases of lyme disease at an Outdoor Wilderness Camp—North Carolina, 2017 and 2019. MMWR, 2020; 69:114–115; doi: 10.1558/5/mmwr.mm6904a5
3.
BarbourAG, MaupinGO, TeltowGJ, et al.Identification of an uncultivable Borrelia species in the hard tick Amblyomma americanum: Possible agent of a Lyme disease-like illness. J Infect Dis, 1996; 173(2):403–409; doi: 10.1093/infdis/173.2.403
4.
BunikisJ, GarpmoU, TsaoJ, et al.Sequence typing reveals extensive strain diversity of the Lyme borreliosis agents Borrelia burgdorferi in North America and Borrelia afzelii in Europe. Microbiology (Reading), 2004; 150(Pt 6):1741–1755; doi: 10.1099/mic.o.26944-0
5.
CasatiS, SagerH, GernL, et al.Presence of potentially pathogenic Babesia sp. for human in Ixodes ricinus in Switzerland. Ann Agric Environ Med, 2016; 13:65–70.
6.
DinizPPVDP, MaggiRG, SchwartzDS, et al.Canine bartonellosis: Serological and molecular prevalence in Brazil and evidence of co-infection with Bartonella henselae and Bartonella vinsonii subsp. berkhoffii. Vet Res, 2007; 38:697–710; doi: 10.1051/vetres:2007023
7.
DuncanAW, CorreaMT, LevineJF, et al.The dog as a sentinel for human infection: Prevalence of Borrelia burgdorferi C6 antibodies in dogs from southeastern and mid-Atlantic states. Vector Borne Zoonotic Dis, 2004; 4(3):221–229; doi: 10.1089/vbz.2004.4.221
8.
DurdenLA, KeiransJE. Nymphs of the Genus Ixodes (Acari: Ixodidae) of the United States: Taxonomy, Identification Key, Distribution, Hosts, and Medical/Veterinary Importance. Monographs, Thomas Say Publications in Entomology, Entomological Society of America: Lanham, MD; 1996.
9.
HerrinBH, ZajacAM, LittleSE. Confirmation of Borrelia burgdorferi sensu stricto and Anaplasma phagocytophilum in Ixodes scapularis, southwestern Virginia. Vector Borne Zoonotic Dis, 2014; 14:821–823; doi: 10.1089/vbz.2014.1661
10.
HicklingGH, KellyJR, AuklandLD, et al.Increasing prevalence of Borrelia burgdorferi sensu sticto-infected blacklegged ticks in Tennessee Valley, Tennessee, USA. Emerg Infect Dis, 2018; 24:1713–1716; doi: 10.3201/eid2409.180343
11.
KakumanuML, PonnusamyL, SuttonHT, et al.Development and validation of an improved PCR method using the 23S-5S intergenic spacer for detection of rickettsiae in Dermacentor variabilis ticks and tissue samples from humans and laboratory animals. J Clin Microbiol, 2016; 54:972–979; doi: 10.1128/JCM.02605-15
12.
LantosPM, NigrovicLE, AuwaerterPG, et al.Geographic expansion of Lyme disease in the southeastern United States, 2000–2014. Open Forum Infect Dis, 2015; 2(4):ofv143; doi: 10.1093/ofid/ofv143
13.
LevineJF, AppersonCS, LevinM, et al.Stable transmission of Borrelia burgdorferi sensu stricto on the Outer Banks of North Carolina. Zoonoses Public Health, 2017; 64(5):337–354; doi: 10.1111/zph.12302
14.
MassungRF, SlaterKG. Comparison of PCR assays for detection of the agent of human granulocytic ehrlichiosis, Anaplasma phagocytophilum. J Clin Microbiol, 2003; 41:717–722; doi: 10.1128/JCM.41.2.717-722.2003
15.
PultorakEL, BreitschwerdtEB. Survey of veterinarians' perceptions of borreliosis in North Carolina. J Am Vet Med Assoc, 2014; 244:592–596.
16.
QuiWG, DykhuizenDE, AcostaMS, et al.Geographic uniformity of the Lyme disease spirochete (Borrelia burgdorferi) and its shared history with tick vector (Ixodes scapularis) in the northeastern United States. Genetics, 2002; 160:833–849; doi: 10.1093/genetics/160.3.833
17.
RebmanAW, YangT, MihmEA, et al.The presenting characteristics of erythema migrans vary by age, sex, duration, and body location. Infection, 2021; 49:685–692; doi: 10.1007/s15010-021-01590-0
