Table 1.
Overview of Borrelia diseases.
| Disease | Vectora | Causative agent(s)a | Clinical symptom(s) |
|---|---|---|---|
| Lyme disease |
I. scapularis (USA) I. pacificus (USA) I. ricinus (Europe, Asia) I. persulcatus (Europe, Asia) |
B. burgdorferi sensu stricto (USA) B. afzelii (Europe, Asia) B. bavariensis (Europe, Asia; formerly B. garinii OspA serotype 4) B. garinii (Europe, Asia) B. spielmanii (Europe, Asia) |
Symptom onset after exposure: early stage generally 3–30 days Influenza-like (e.g., mild fever, malaise, myalgia/arthralgia; B. burgdorferi s.s.) Erythema migrans (B. burgdorferi s.s., B. afzelii) Symptom onset after exposure: late stage generally >30 days Arthritis Acrodermatitis chronica atrophicans (B. afzelii) Neurological (Lyme neuroborreliosis, e.g., numbness, Bell’s palsy, stiffness of neck, declining memory, sleep disorders; B. burgdorferi s.s., B. bavariensis) |
| Tick-borne relapsing fever |
O. hermsi O. turicata O. parkeri O. moubata |
B. hermsiiB. turicatae B. parkerii B. duttonii |
Symptom onset: ca. 7 days Influenza-like Recurring high fever Headache Myalgia Arthritis Approximately 3–10 febrile episodes (relapses) occur; mortality rates are variable but generally less than 5% |
| Hard tick-borne relapsing fever/Borrelia miyamotoi disease |
I. scapularisI pacificus I ricinus I. persulcatus |
B. miyamotoi | Symptom onset after exposure: ca. 15 days (85) Influenza-like Most common: Fever Malaise Headache Chills Arthritis/arthralgia Meningoencephalitis (immunocompromised patients) Rare (less than 10% of patients): Rash/erythema migrans Gastrointestinal (e.g., vomiting, nausea, diarrhea) Cardiac/respiratory (shortness of breath) Neurological (e.g., dizziness, confusion) Stiffness of neck |
| Louse-borne relapsing fever | P. humanus humanus | B. recurrentis | Symptom onset after exposure: ca. 4–8 days Recurring high fever Malaise Headache Chills Meningism Myalgia Nausea Vomiting Approximately 3–5 relapses occur; mortality rate varies greatly (30–70% without treatment during outbreaks) |
aCommonly encountered and studied vectors and causative agents are listed.