Borrelia mayonii Lyme Disease Detected in New York for the First Time, Raising Concerns About Geographic Spread
核心洞察
A New York resident tested positive for Borrelia mayonii (搜索), marking the first locally acquired case of this rare Lyme disease (搜索) variant outside Minnesota and Wisconsin.
B. mayonii causes more severe symptoms than typical Lyme disease (搜索), including high fever, diffuse rashes, gastrointestinal distress, and neurological manifestations due to bacterial levels 1,000 times higher in the blood.
The patient recovered fully after antibiotic treatment, and experts emphasize that standard Lyme disease (搜索) therapies like doxycycline remain effective against this pathogen.
A resident of Herkimer County, New York, has tested positive for Borrelia mayonii (搜索), a rare bacterial species that causes Lyme disease (搜索) with more severe symptoms than the typical Borrelia burgdorferi (搜索) infection. The case, reported by the Centers for Disease Control and Prevention (搜索) on June 4, represents the first evidence of locally acquired B. mayonii infection in a New York resident and the first detection of the pathogen in New York ticks.
The patient had spent time outdoors and had not recently traveled, according to the CDC's Morbidity and Mortality Weekly Report. Investigators subsequently found ticks positive for B. mayonii on the individual's wooded property. The patient made a full recovery after treatment with an antibiotic.
A Distinct and More Severe Clinical Presentation
B. mayonii was first discovered in 2016 by researchers at the Mayo Clinic in Rochester, Minnesota, and was named in honor of the Mayo brothers who founded the institution. Until this New York case, fewer than 20 human infections had been reported — all confined to Minnesota and Wisconsin.
Dr. Bobbi Pritt, chair of the division of clinical microbiology at the Mayo Clinic and one of the scientists who discovered the organism, explained that the bacterial load in B. mayonii infections is dramatically higher than in typical Lyme disease (搜索). "It looks like Borrelia mayonii (搜索), the newer discovered organism, just reaches a very, very high level of bacteria in the blood, and that might be why some of the symptoms are more severe as well," Pritt said.
Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security (搜索), noted that the level of B. mayonii bacteria in patients' blood is 1,000 times higher than with B. burgdorferi, resulting in patients who can be sicker and experience high fever.
While traditional Lyme disease (搜索) typically presents with fever, chills, headache, fatigue, muscle and joint aches, and a characteristic bull's-eye rash, B. mayonii infections manifest differently. Patients have exhibited more diffuse or widespread rashes — including one case where a man had large red spots covering his entire body. Gastrointestinal symptoms such as nausea and vomiting are more prominent, as are neurological symptoms including double vision and severe headache. One young patient experienced severe somnolence, or excessive drowsiness, that required hospitalization. "The parents couldn't rouse the child, which was very worrisome," Pritt recalled.
When asked whether this represents a more alarming form of Lyme disease (搜索), Pritt responded: "Yes, correct."
Diagnostic Challenges
Standard Lyme disease (搜索) diagnosis relies on serology — blood tests that detect antibodies to Lyme bacteria. However, these tests cannot differentiate between B. burgdorferi and B. mayonii. Distinguishing between the two species requires PCR (polymerase chain reaction) testing, which is not widely available in clinical settings.
"There probably are very likely more cases that are just patients being tested by serology and getting a positive result, and we just assume it's the routine Borrelia burgdorferi (搜索) Lyme disease (搜索)," Pritt said. "Without PCR, you never would know."
Treatment Remains Unchanged
Despite the more severe symptom profile, the treatment approach for B. mayonii infection is identical to that for traditional Lyme disease (搜索). Both experts confirmed that patients receive a standard course of antibiotics such as doxycycline, and the New York patient recovered fully with this regimen.
Geographic Spread and Tick Ecology
Both B. burgdorferi and B. mayonii are transmitted by the blacklegged tick, also known as the deer tick. The New York State Health Department conducted a broader search of more than 1,500 ticks from 24 New York counties but did not find B. mayonii again, suggesting the pathogen is currently contained to a very small area.
Douglas Norris, a professor of molecular microbiology and immunology at the Johns Hopkins Bloomberg School of Public Health, said the bacteria has likely been present in New York ticks for a couple of years. He suggested that an infected tick may have hitched a ride on a bird migrating from Minnesota or Wisconsin.
Just 0.2% of nymphs collected throughout New York carried B. mayonii, compared to about 1% of adult ticks. By contrast, B. burgdorferi infects approximately one-quarter of nymphs in the Northeast and half of all adult ticks. Nymphs, which are about the size of a poppy seed, are typically responsible for spreading Lyme disease (搜索) because they are difficult to detect. "A big tick a human will usually notice, but those little guys not so much," Norris said.
Broader Context of Rising Lyme Disease (搜索)
Lyme disease (搜索) cases have surged across the Northeast in recent years. Between 2020 and 2024, the incidence of Lyme disease in New York state increased by nearly 450%, from about 37 cases per 100,000 people in 2020 to nearly 165 cases per 100,000 in 2024. Climate change is expanding the geographic "sweet spot" for tick-borne disease transmission northward, toward Maine and southern Canada.
Even in Minnesota, where B. mayonii has been detected for years, it accounts for only about two of the nearly 3,000 Lyme disease (搜索) cases reported annually. Pritt expects B. burgdorferi to remain the predominant cause of Lyme disease in the United States.
"While this finding was unexpected, we do know that a range of ticks and tick-borne disease can change geographically over time," a spokesperson from the New York State Health Department said.
Prevention Remains Key
Pritt emphasized practical prevention measures: staying in the middle of trails while hiking to avoid taller grasses that harbor ticks, wearing long sleeves and tucking pants into socks, using 30% DEET or oil of lemon eucalyptus insect repellent, and performing thorough tick checks after outdoor exposure.
"We don't want people to be afraid of the outdoors," Pritt said. "But ticks can transfer a whole host of things, other parasitic and viral diseases, so the bottom line is that people need to protect themselves from tick bites."
Adalja echoed this sentiment, noting that the discovery should not cause undue alarm. "I don't think that this should freak people out, but I think it underscores the fact that tickborne diseases are a real thing, and that ticks can transmit multiple different pathogens," he said.