Borrelia Miyamotoi Disease Fact Sheet

Total Page:16

File Type:pdf, Size:1020Kb

Borrelia Miyamotoi Disease Fact Sheet Borrelia miyamotoi Disease What is Borrelia miyamotoi every year. Blacklegged ticks are small; disease? adults are about the size of a sesame seed Borrelia miyamotoi disease is one of many and nymphs (young ticks) are about the size tickborne diseases in Minnesota. The of a poppy seed. Due to their small size, a disease agent is closely related to the person may not know they have been bitten bacteria that cause tickborne relapsing by a tick. fever and distantly related to the bacteria that cause Lyme disease. It was first What are the symptoms of identified as a cause of human illness in Borrelia miyamotoi disease? 2011 with the first case reported in a Minnesota resident in 2016. Since then, low The spectrum of illness is still being numbers of cases have been reported in described for this new disease. However, Minnesota each year. the most common symptoms reported to date include: How do people get Borrelia ▪ Fever or chills ▪ Headache miyamotoi disease? ▪ Muscle aches People can get B. miyamotoi disease most ▪ Tiredness or weakness likely through the bite of a blacklegged tick (deer tick) that is infected with the bacteria. Similar to tickborne relapsing fever, some Not all blacklegged ticks carry these patients with illness due to B. miyamotoi bacteria and not all people bitten by a have described recurring symptoms prior to blacklegged tick will get sick. A tick needs to diagnosis and treatment. Severe illness be attached to a person for a certain length affecting the nervous system, such as of time before it can cause disease. While meningoencephalitis (inflammation of the the minimum time interval is not known for brain and membranes surrounding the B. miyamotoi, the disease agent can be brain), have also been reported. transmitted within the first 24 hours of tick attachment. How is Borrelia miyamotoi Blacklegged ticks live on the ground in areas disease diagnosed? that are wooded or have lots of brush. The ticks search for hosts at or near ground If a person suspects B. miyamotoi disease, level and grab onto a person or animal as they should contact a doctor as soon as they walk by. Ticks do not jump, fly, or fall possible for diagnosis and treatment. The from trees. diagnosis is based on a history of exposure to tick habitat, a physical examination, and In Minnesota, the months of April through laboratory tests to confirm the diagnosis. July and September through October are the greatest risk for being bitten by a blacklegged tick. Risk peaks in June or July BORRELIA MIYAMOTOI DISEASE How is Borrelia miyamotoi ▪ Tumble dry clothing and gear on high disease treated? heat for at least 60 minutes after spending time in areas where ticks live. Borrelia miyamotoi disease is treated with ▪ Talk with your veterinarian about safe antibiotics. It is likely possible to get this and effective products you can use to tickborne disease more than once so protect your pet. continue to protect yourself from tick bites and contact your doctor if you suspect you Check for ticks at least once a day after may have symptoms of B. miyamotoi spending time in areas where ticks live: disease. ▪ Inspect your entire body closely with a mirror, especially hard-to-see areas How can I reduce my risk? such as the groin and armpits. ▪ Remove ticks as soon as you find one. There is currently no human vaccine ▪ Use tweezers or your fingers to grasp available for B. miyamotoi disease. the tick close to its mouth. Pull the tick Reducing exposure to ticks is the best outward slowly and gently. Clean the defense against tickborne diseases. area with soap and water. Protect yourself from tick bites: ▪ Examine your gear and pets for ticks. ▪ Know where ticks live and when they are active. Manage areas where ticks live: ▪ Blacklegged ticks live in wooded or ▪ Mow lawns and trails frequently. brushy areas. ▪ Remove leaves and brush. ▪ In Minnesota, blacklegged tick ▪ Create a barrier of wood chips or rocks activity is greatest from April – July between mowed lawns and woods. and September – October. ▪ Use a safe and effective tick repellent if you spend time in or near areas where Minnesota Department of Health ticks live. Follow the product label and Vectorborne Diseases Unit PO Box 64975 reapply as directed. St. Paul, MN 55164 ▪ Use DEET-based repellents (up to 651-201-5414 30%) on skin or clothing. Do not www.health.state.mn.us use DEET on infants under two months of age. ▪ Pre-treat clothing and gear with 2/28/2018 permethrin-based repellents to To obtain this information in a different format, call: protect against tick bites for at 651-201-5414. Printed on recycled paper. least two weeks without reapplication. Do not apply permethrin to your skin. ▪ Wear light-colored clothing to help you spot ticks more easily. Wear long- sleeved shirts and pants to cover exposed skin. 2 .
Recommended publications
  • Tick-Borne Diseases (TBD)
    Tick-Borne Diseases (TBD) Philip Molloy, MD March, 2018 Disclosure Dr. Molloy is Medical Director of Tick-Borne Diseases at Imugen, a Division of Oxford Immunotec, Inc. Assistant Clinical Professor of Medicine, Tufts Medical School, Boston, MA Staff physician BID Plymouth and Nantucket Cottage Hospital Objectives Describe epidemiology & clinical presentations of tick-borne diseases (TBD) Describe TBD diagnostic testing & result interpretation for both single and co-infected TBD patients Take Home Message: These infections are prevalent, often challenging to differentiate from one another, and co-infections are common Pre-test: True or False? Q1: If the whole blood Lyme PCR test is positive, and all the Serologies are negative, it is likely that the PCR is a false positive test result. Q2: After treating a patient for Lyme disease, a follow-up Lyme test is recommended; if it is still positive, the patient should be re-treated. Common Tick-Borne Diseases Which one does not fit in Lyme disease with the others? Babesiosis B. miyamotoi disease Transmitted by the Deer Tick (Ixodes) HGA Transmitted by the HME Lone Star Tick Tickborne Diseases of the United States. CDC. https://www.cdc.gov/lyme/resources/tickbornediseases.pdf. Accessed August 30. 2017. B. miyamotoi. https://www.cdc.gov/ticks/miyamotoi.htm. Accessed August 30, 2017. Methods for Diagnosis of Tick-Borne Disease Clinical •Symptoms Lyme- Erythema migrans Evaluation RMSF – Maculopapular rash •Culture Direct •Direct smear microscopy Tests •PCR Indirect •Serology Tests Aguero-Rosenfeld ME, et al. Diagnosis of Lyme Borreliosis. Clinical Microbiology Reviews. 2005;18(3):484-509. Tickborne Diseases of the United States.
    [Show full text]
  • Detection of Anaplasma Phagocytophilum, Babesia Microti, Borrelia Burgdorferi, Borrelia Miyamotoi, and Powassan Virus in Ticks by A
    OBSERVATION Clinical Science and Epidemiology crossm Detection of Anaplasma phagocytophilum, Babesia microti, Borrelia burgdorferi, Borrelia miyamotoi, and Powassan Virus in Ticks by a Multiplex Real-Time Reverse Downloaded from Transcription-PCR Assay Rafal Tokarz,a Teresa Tagliafierro,a D. Moses Cucura,b Ilia Rochlin,b Stephen Sameroff,a W. Ian Lipkina Center for Infection and Immunity, Mailman School of Public Health, Columbia University, New York, New York, USAa; Division of Vector Control, Suffolk County Department of Public Works, Yaphank, New York, USAb http://msphere.asm.org/ ABSTRACT Ixodes scapularis ticks are implicated in transmission of Anaplasma phagocytophilum, Borrelia burgdorferi, Borrelia miyamotoi, Babesia microti, and Powas- Received 29 March 2017 Accepted 30 March san virus. We describe the establishment and implementation of the first multiplex 2017 Published 19 April 2017 Citation Tokarz R, Tagliafierro T, Cucura DM, real-time PCR assay with the capability to simultaneously detect and differentiate all Rochlin I, Sameroff S, Lipkin WI. 2017. Detection five pathogens in a single reaction. The application of this assay for analysis of ticks of Anaplasma phagocytophilum, Babesia at sites in New York and Connecticut revealed a high prevalence of B. microti in microti, Borrelia burgdorferi, Borrelia miyamotoi, and Powassan virus in ticks by a multiplex real- ticks from Suffolk County, NY. These findings are consistent with reports of a higher time reverse transcription-PCR assay. mSphere incidence of babesiosis from clinicians managing the care of patients with tick-borne 2:e00151-17. https://doi.org/10.1128/mSphere diseases in this region. .00151-17. Editor Katherine McMahon, University of on May 30, 2017 by guest IMPORTANCE The understanding of pathogen prevalence is an important factor in Wisconsin—Madison the determination of human risks for tick-borne diseases and can help guide diagno- Copyright © 2017 Tokarz et al.
    [Show full text]
  • Lyme Disease: Diversity of Borrelia Species in California and Mexico Detected Using a Novel Immunoblot Assay
    healthcare Article Lyme Disease: Diversity of Borrelia Species in California and Mexico Detected Using a Novel Immunoblot Assay Melissa C. Fesler 1, Jyotsna S. Shah 2, Marianne J. Middelveen 3, Iris Du Cruz 2, Joseph J. Burrascano 2 and Raphael B. Stricker 1,* 1 Union Square Medical Associates, 450 Sutter Street, Suite 1504, San Francisco, CA 94108, USA; [email protected] 2 IGeneX Reference Laboratory, Milpitas, CA 95035, USA; [email protected] (J.S.S.); [email protected] (I.D.C.); [email protected] (J.J.B.) 3 Atkins Veterinary Services, Calgary, AB, T3B 4C9, Canada; [email protected] * Correspondence: [email protected] Received: 7 March 2020; Accepted: 10 April 2020; Published: 14 April 2020 Abstract: Background: With more than 300,000 new cases reported each year in the United States of America (USA), Lyme disease is a major public health concern. Borrelia burgdorferi sensu stricto (Bbss) is considered the primary agent of Lyme disease in North America. However, multiple genetically diverse Borrelia species encompassing the Borrelia burgdorferi sensu lato (Bbsl) complex and the Relapsing Fever Borrelia (RFB) group are capable of causing tickborne disease. We report preliminary results of a serological survey of previously undetected species of Bbsl and RFB in California and Mexico using a novel immunoblot technique. Methods: Serum samples were tested for seroreactivity to specific species of Bbsl and RFB using an immunoblot method based on recombinant Borrelia membrane proteins, as previously described. A sample was recorded as seropositive if it showed immunoglobulin M (IgM) and/or IgG reactivity with at least two proteins from a specific Borrelia species.
    [Show full text]
  • Emerging Tickborne Diseases in New Hampshire
    THIS IS AN OFFICIAL NH HEALTH ALERT Distributed by the NH Health Alert Network [email protected] June 01, 2017, 1100 EDT (11:00 AM EDT) NH-HAN 20170601 Emerging Tickborne Diseases in New Hampshire Key Points and Recommendations: 1. Blacklegged ticks transmit four different infections in NH: Lyme, Anaplasma, Babesia, and Powassan. They may transmit other emerging infections. 2. NH has one of the highest rates of Lyme disease in the nation, and 50-60% of blacklegged ticks sampled in NH have been found to be infected with Borrelia burgdorferi, the bacterium that causes Lyme disease. 3. Powassan was identified in two NH residents during past seasons: 2013 and 2016. While uncommon, Powassan can cause a debilitating neurological illness, so providers should maintain an index of suspicion for patients presenting with an unexplained meningoencephalitis. a. Testing for Powassan can be arranged through the NH Public Health Laboratories by calling the NH DPHS Bureau of Infectious Disease Control at the number below. 4. Providers should ask patients with suspected Babesiosis whether they have donated blood or received a blood transfusion. 5. For any non-Lyme tickborne disease, providers should determine most likely geographical area for exposure and report that information on the case report form as this information will help define the location of tickborne disease in New Hampshire. 6. If testing for Lyme disease is negative, yet you still suspect a tickborne disease, consider testing for other pathogens, such as Borrelia miyamotoi. 7. Report all tickborne diseases, confirmed or suspected, to the NH DPHS Bureau of Infectious Disease Control at 603-271-4496 (after hours 603-271-5300).
    [Show full text]
  • Borrelia Miyamotoi
    Borrelia miyamotoi Frequently Asked Questions What is Borrelia miyamotoi? Borrelia miyamotoi is a type of bacteria that is closely related to the bacteria that cause tick-borne relapsing fever. It is more distantly related to the bacteria that cause Lyme disease. How is B. miyamotoi spread? B. miyamotoi is spread by the bite of an infected black-legged or “deer” tick (Ixodes scapularis). Deer ticks can also carry the germs that cause Lyme disease, babesiosis, anaplasmosis and Powassan virus. Deer ticks can spread more than one type of germ in a single bite. When can I get B. miyamotoi? Young ticks (nymphs) are most active during the warm weather months between May and July. Adult ticks are most active during the fall and spring but will also be out searching for a host any time that winter temperatures are above freezing. What are the symptoms of B. miyamotoi infection? Symptoms associated with B. miyamotoi include: • Fever • Chills • Fatigue • Headache • Joint pain (arthralgia) • Muscle pain (myalgia) Other symptoms reported are: • Nausea • Dizziness • Confusion • Light sensitivity (photophobia) • Vertigo • Rash • Shortness of breath (dyspnea) • Abdominal pain • Diarrhea • Lack of appetite How soon after a tick bite do symptoms occur? The incubation period for B. miyamotoi can range from days to weeks. Specific ranges are unknown. Is B. miyamotoi common? It is not yet known how common this disease is in New Jersey. Results from a recent study suggest this is an infrequent cause of illness occurring during the late spring and summer (peak tick season). Where do cases of B. miyamotoi occur? B.
    [Show full text]
  • First Detection of Borrelia Miyamotoi in Ixodes Ricinus Ticks from Northern Italy
    Ravagnan et al. Parasites & Vectors (2018) 11:130 https://doi.org/10.1186/s13071-018-2713-z SHORT REPORT Open Access First detection of Borrelia miyamotoi in Ixodes ricinus ticks from northern Italy Silvia Ravagnan1†, Laura Tomassone2†, Fabrizio Montarsi1, Aleksandra Iwona Krawczyk3, Eleonora Mastrorilli1, Hein Sprong3, Adelaide Milani1, Luca Rossi2 and Gioia Capelli1* Abstract Background: Borrelia miyamotoi is a spirochete transmitted by several ixodid tick species. It causes a relapsing fever in humans and is currently considered as an emerging pathogen. In Europe, B. miyamotoi seems to occur at low prevalence in Ixodes ricinus ticks but has a wide distribution. Here we report the first detection of B. miyamotoi in Ixodes ricinus ticks collected in two independent studies conducted in 2016 in the north-eastern and north-western Alps, Italy. Results: Threeoutof405nymphs(0.74%)testedpositiveforBorrelia miyamotoi.Inparticular,B. miyamotoi was found in 2/365 nymphs in the western and in 1/40 nymphs in the eastern alpine area. These are the first findings of B. miyamotoi in Italy. Conclusions: Exposure to B. miyamotoi and risk of human infection may occur through tick bites in northern Italy. Relapsing fever caused by Borrelia miyamotoi has not yet been reported in Italy, but misdiagnoses with tick-borne encephalitis, human granulocytic anaplasmosis or other relapsing fever can occur. Our findings suggest that B. miyamotoi should be considered in the differential diagnosis of febrile patients originating from Lyme borreliosis endemic regions. The distribution of this pathogen and its relevance to public health need further investigation. Keywords: Borrelia miyamotoi, Ixodes ricinus, Zoonosis, Northern Italy Background and epidemiology of B.
    [Show full text]
  • Prevalence and Geographic Distribution of Borrelia Miyamotoi in Host-Seeking Ixodes Pacificus (Acari: Ixodidae) Nymphs in Mendocino County, California
    HHS Public Access Author manuscript Author ManuscriptAuthor Manuscript Author J Med Entomol Manuscript Author . Author Manuscript Author manuscript; available in PMC 2018 November 04. Published in final edited form as: J Med Entomol. 2018 May 04; 55(3): 711–716. doi:10.1093/jme/tjx258. Prevalence and Geographic Distribution of Borrelia miyamotoi in Host-Seeking Ixodes pacificus (Acari: Ixodidae) Nymphs in Mendocino County, California Geoffrey E. Lynn1, Christine B. Graham1, Kalanthe Horiuchi1, Lars Eisen1, Tammi L. Johnson1, Robert S. Lane2, and Rebecca J. Eisen1,3 1Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, 3156 Rampart Road, Fort Collins, CO 80521 2Department of Environmental Science, Policy & Management, University of California, Berkeley, CA 94720 Abstract Borrelia miyamotoi is an increasingly recognized human pathogen transmitted by Ixodes ticks in the Northern Hemisphere. In North America, infection prevalences of B. miyamotoi are characteristically low (<10%) in Ixodes scapularis (Say; Acari: Ixodidae) and Ixodes pacificus (Cooley & Kohls; Acari: Ixodidae), both of which readily bite humans. We tested 3,255 host- seeking I. pacificus nymphs collected in 2004 from 79 sites throughout Mendocino County in north-coastal California for presence of B. miyamotoi. The collection sites represented a variety of forest types ranging from hot, dry oak woodlands in the southeast, to coastal redwoods in the west, and Ponderosa pine and Douglas fir-dominated areas in the northern part of the county. We found that B. miyamotoi was geographically widespread, but infected I. pacificus nymphs infrequently (cumulative prevalence of 1.4%). Infection prevalence was not significantly associated with geographic region or woodland type, and neither density of host-seeking nymphs, nor infection with Borrelia burgdorferi sensu stricto was associated with B.
    [Show full text]
  • BORRELIA MIYAMOTOI: a NEWLY DISCOVERED TICK-BORNE INFECTION Ticks Have Many Different Bacteria and Other Or
    News VOLUME 6, ISSUE 1 F A L L 2 0 1 3 BOARD OF DIRECTORS WHAT YOU CAN'T MEAS URE, YOU CAN'T DIAGNOSE AND CURE! John Aucott, Trustee/Pres. Trustees Eric Becker NIST (the National Institute of Standards and Tech- Dr. Aucott gave the keynote address and also led a Joseph Hardiman nology) is not a name people know, like the CDC or lunchtime discussion on biorepository strategies Terral Jordan NIH. While not as central to health care and Lyme (which was not webcast). Lawrence Macks disease, this federal agency has a very important Dale Mathias mission. NIST is a non-regulatory federal agency What you can't measure, you can't diagnose and Decatur Miller within the U.S. Department of Commerce whose cure! One of the key conclusions from the workshop Ryan Purdue mission is to promote U.S. innovation and competi- was the widespread recognition of the critical need Adena W. Testa tiveness by advancing measurement science, stand- for high quality and well-defined blood samples to Alex Mason ards, and technology in ways that improve our advance and validate innovative technologies for quality of life, including diagnostic tests for illness. improved Lyme disease diagnostics and treat- ments. There was near universal agreement that the SCIENTIFIC Our nation's top Lyme disease researchers and phy- currently available blood tests for Lyme disease ADVISORY sician scientists recently attended a Lyme disease have inherent gaps in early diagnostic sensitivity. BOARD conference at NIST on June 6th. The workshop ad- Tim Krohe, MD dressed the challenges of measurement in Lyme The NIST conference reinforced the relevance of the Instructor, Dept.
    [Show full text]
  • Borrelia Miyamotoi–Associated Neuroborreliosis in Immunocompromised Person
    DISPATCHES Borrelia miyamotoi–Associated Neuroborreliosis in Immunocompromised Person Katharina Boden, Sabine Lobenstein, Elsteraue municipality (Saxony-Anhalt, Germany) during Beate Hermann, Gabriele Margos, Volker Fingerle June and July 2015 but had no recent travel history. On examination, she had slight neck stiffness but no other Borrelia miyamotoi is a newly recognized human pathogen in notable findings. the relapsing fever group of spirochetes. We investigated a A lumbar puncture was performed to assess the patient case of B. miyamotoi infection of the central nervous system for viral or lymphomatous meningitis. Cerebrospinal fluid resembling B. burgdorferi–induced Lyme neuroborreliosis and determined that this emergent agent of central nervous (CSF) showed a pleocytosis of 70 leukocytes/mL (refer- system infection can be diagnosed with existing methods. ence 0–5 leukocytes/mL) and elevated protein at 1,718 mg/L (reference 150–400 mg/L); albumin quotient (Qalb) 34.8% (reference <9%), lactate 5.58 mmol/L (1.2–2.1 he tickborne relapsing fever spirochete Borrelia miya- mmo/L), and glucose quotient 0.45 (>0.5); and an intra- Tmotoi was described in 1994 but only recently was rec- thecal IgM synthesis of 18%. The greatly elevated lactate ognized as a human pathogen (1). This spirochete is present and highly increased Qalb and protein made a viral cause in Ixodes ticks across the Northern Hemisphere, compa- unlikely. Pappenheim staining of a cytospin preparation of rable to the distribution of B. burgdorferi sensu lato, but CSF revealed a mixed cell population (32% polymorpho- reported cases are still rare (2,3). Thus far, only 2 cases of nuclear leukocytes, 61% lymphocytes, and 7% monocytes) central nervous system infection have been reported, both with heterogeneous morphology of lymphocytes that did with a chronic course and both in immunocompromised not suggest lymphomatous meningitis.
    [Show full text]
  • Isolation of Borrelia Miyamotoi and Other Borreliae Using a Modified
    www.nature.com/scientificreports OPEN Isolation of Borrelia miyamotoi and other Borreliae using a modifed BSK medium Adam J. Replogle1, Christopher Sexton1, John Young1, Luke C. Kingry1, Martin E. Schriefer1, Marc Dolan1, Tammi L. Johnson1,4, Neeta P. Connally2, Kerry A. Padgett3 & Jeannine M. Petersen1* Borrelia spirochetes are the causative agents of Lyme borreliosis (LB) and relapsing fever (RF). Despite the steady rise in infections and the identifcation of new species causing human illness over the last decade, isolation of borreliae in culture has become increasingly rare. A modifed Barbour-Stoenner- Kelly (BSK) media formulation, BSK-R, was developed for isolation of the emerging RF pathogen, Borrelia miyamotoi. BSK-R is a diluted BSK-II derivative supplemented with Lebovitz’s L-15, mouse and fetal calf serum. Decreasing the concentration of CMRL 1066 and other components was essential for growth of North American B. miyamotoi. Sixteen B. miyamotoi isolates, originating from Ixodes scapularis ticks, rodent and human blood collected in the eastern and upper midwestern United States, were isolated and propagated to densities > 108 spirochetes/mL. Growth of fve other RF and ten diferent LB borreliae readily occurred in BSK-R. Additionally, primary culture recovery of 20 isolates of Borrelia hermsii, Borrelia turicatae, Borrelia burgdorferi and Borrelia mayonii was achieved in BSK-R using whole blood from infected patients. These data indicate this broadly encompassing borreliae media can aid in in vitro culture recovery of RF and LB spirochetes, including the direct isolation of new and emerging human pathogens. Primary culture recovery is ofen considered the benchmark for proof of infection, but for many bacterial infec- tions, including Borrelia spp., this proof is rarely achieved.
    [Show full text]
  • A Spotlight on Emerging Diseases
    FEATURE Powassan virus Powassan virus (POW) is a tickborne fla- vivirus that can cause severe disease in hu- mans. The disease is considered rare, and although human cases have traditionally only been reported sporadically, it is be- coming more common. Most cases report exposure in the northeastern United States and in the upper Midwest. POW typically presents with neurologic symptoms, most commonly encephalitis or meningitis, after an incubation period of one to four weeks. Milder, even subclinical, infections occur, although they are likely underreported. Long-term sequelae after infection occur in approximately 50 percent of cases and 10-15 percent are fatal. THE CHANGING LANDSCAPE OF From 2008 through 2018, Minnesota TICKBORNE DISEASE IN MINNESOTA: reported 37 cases of POW, with an average of three cases per year. Cases were 73 per- cent male and the median age was 60 years A spotlight on (range, 0–75 years). Clinically, 89 percent of cases had meningitis or encephalitis with fever, headache, confusion and weak- emerging diseases ness also commonly reported. Two of Minnesota’s cases were fatal. BY JENNA BJORK, DVM, MPH, AND ELIZABETH SCHIFFMAN, MPH, MA Diagnostic testing for POW is not widely available, and is primarily per- he risk for tickborne disease in Min- More than just a pest, this tick has become formed at public health laboratories or nesota has expanded over the years, a significant disease threat to people living the Centers for Disease Control (CDC). Tnot only geographically, but also in around, working in and enjoying the great Serologic and molecular testing can be or- terms of the number of infections pos- outdoors while in forested areas of the dered through the Minnesota Department sible.
    [Show full text]
  • Characterization of Infectious Isolates of Borrelia Burgdorferi in North Dakota, Bb0399 and Bbb28 in B
    University of North Dakota UND Scholarly Commons Theses and Dissertations Theses, Dissertations, and Senior Projects January 2018 Characterization Of Infectious Isolates Of Borrelia Burgdorferi In North Dakota, Bb0399 And Bbb28 In B. Burgdorferi, And Borrelia Miyamotoi In Vitro And In Vivo Brandee Lynn Stone Follow this and additional works at: https://commons.und.edu/theses Recommended Citation Stone, Brandee Lynn, "Characterization Of Infectious Isolates Of Borrelia Burgdorferi In North Dakota, Bb0399 And Bbb28 In B. Burgdorferi, And Borrelia Miyamotoi In Vitro And In Vivo" (2018). Theses and Dissertations. 2356. https://commons.und.edu/theses/2356 This Dissertation is brought to you for free and open access by the Theses, Dissertations, and Senior Projects at UND Scholarly Commons. It has been accepted for inclusion in Theses and Dissertations by an authorized administrator of UND Scholarly Commons. For more information, please contact [email protected]. CHARACTERIZATION OF INFECTIOUS ISOLATES OF BORRELIA BURGDORFERI IN NORTH DAKOTA, BB0399 AND BBB28 IN B. BURGDORFERI, AND BORRELIA MIYAMOTOI IN VITRO AND IN VIVO by Brandee Lynn Stone Masters of Science, California State University, Chico, 2011 A Dissertation Submitted to the Graduate Faculty of the University of North Dakota In partial fulfillment of the requirements for the degree of Doctor of Philosophy in Microbiology and Immunology Grand Forks, North Dakota May 2018 i Copyright 2018 Brandee Lynn Stone ii PERMISSION Title: CHARACTERIZATION OF INFECTIOUS ISOLATES OF BORRELIA BURGDORFERI IN NORTH DAKOTA, BB0399 AND BBB28 IN B. BURGDORFERI, AND BORRELIA MIYAMOTOI IN VITRO AND IN VIVO Department: Microbiology and Immunology Degree: Doctor of Philosophy In presenting this dissertation in partial fulfillment of the requirements for a graduate degree from the University of North Dakota, I agree that the library of this University shall make it freely available for inspection.
    [Show full text]