Borrelia mayonii (Lyme Disease) Information for Health Professionals

Lyme disease due to Borrelia mayonii is a bacterial illness transmitted to humans by the blacklegged (deer) tick. Human illness due to B. mayonii was first identified in a Minnesota resident in 2013 and determined to be a cause of Lyme disease in 2016. 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 some commercial 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 Lyme disease due to B. mayonii have been successfully treated with the same antibiotics used for Lyme disease due to B. burgdorferi. 

Guidelines

• CDC: Tickborne Diseases of the United States
  CDC Handbook, designed as a way for health care providers to access information on tickborne diseases and tick identification. 
• IDSA: AAN/ACR/IDSA 2020 Guidelines for the Prevention, Diagnosis and Treatment of Lyme Disease
  Clinical Practice Guidelines by the Infectious Diseases Society of America (IDSA), American Academy of Neurology (AAN), and American College of Rheumatology (ACR).

Reporting

• Reporting Lyme Disease 
  Minnesota Rules Governing Communicable Diseases require Lyme Disease (Borrelia burgdorferi and B. mayonii) 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.