Molecular Characterization of<i>Borrelia burgdorferi</i>from Case of Autochthonous Lyme Arthritis

LETTERS and the EMIDA ERA-NET and INIA grant APHAEA. Miguel Delibes-Mateos, Catarina Ferreira, Francisco Carro, Marco A. Escudero, and Christian Gortazar Author affiliations: Instituto de Investig- acion en Recursos Cinegeticos, a collab- orative agency of the Consejo Superior de Investigaciones Cientificas, Universidad de Castilla-La Mancha, and Junta de Co- munidades de Castilla-La Mancha, Ciudad Real, Spain (M. Delibes-Mateos, C. Gor- tazar); Trent University, Peterborough, Ontario, Canada (C. Ferreira); Estacion Biologica de Donana, Seville, Spain (F. Carro); and Ebronatura, Zaragoza, Spain (M.A. Escudero) DOI: http://dx.doi.org/10.3201/eid2012.140517 References 1. Delibes-Mateos M, Ferreras P, Villafuerte R. European rabbit population trends and associated factors: a review of the situation in the Iberian Peninsula. Mammal Review. 2009;39:124–40. http:// dx.doi.org/10.1111/j.1365-2907.2009. 00140.x 2. Calvete C. Modeling the effect of population dynamics on the impact of rabbit hemorrhagic disease. Conserv Biol. 2006;20:1232–41. http://dx.doi. org/10.1111/j.1523-1739.2006.00371.x 3. Le Gall-Recule G, Zwingelstein F, Boucher S, Le NB, Plassiart G, Portejoie Y, et al. Detection of a new variant of rab- bit haemorrhagic disease virus in France. Vet Rec. 2011;168:137–8. http://dx.doi. org/10.1136/vr.d697 4. Dalton KP, Nicieza I, Balseiro A, Muguerza MA, Rosell JM, Casais R, et al. Variant rabbit hemorrhagic disease virus in young rabbits, Spain. Emerg Infect Dis. 2012;18:2009–12. http://dx. doi.org/10.3201/eid1812.120341 5. Calvete C, Calvo JH, Sarto P. Deteccion de una nueva variante del virus de la en- fermedad hemorragica en conejos silves- tres en Espana. In: Abstracts of the 37th symposium de cunicultura de ASESCU, 2012 May 24–25. Barbastro (Spain): Aso- ciacion Espanola de Cunicultura; 2012. 6. Dalton KP, Nicieza I, Abrantes J, Esteves PJ, Parra F. Spread of new variant of RHDV in domestic rabbits on the Iberian Peninsula. Vet Microbiol. 2014;169:67–73. http:// dx.doi.org/10.1016/j.vetmic.2013.12.015 7. Abrantes J, Lopes AM, Dalton KP, Melo P, Correia JJ, Ramada M, et al. New vari- ant of rabbit hemorrhagic disease vi- rus, Portugal, 2012–2013. Emerg Infect Dis. 2013;19:1900–2. http://dx.doi.org/ 10.3201/eid1911.130908 8. Williams D, Acevedo P, Gortazar C, Escudero MA, Labarta JL, Marco MA, et al. Hunting for answers: rabbit (Oryc- tolagus cuniculus) population trends in northeastern Spain. European Journal of Wildlife Research. 2007;53:19–28. http://dx.doi.org/10.1007/s10344-006- 9. Delibes-Mateos M, Delibes M, Ferreras P, Villafuerte R. Key role of European rab- bits in the conservation of the western Mediterranean Basin hotspot. Conserv Biol. 2008;22:1106–17. http://dx.doi.org/ 10.1111/j.1523-1739.2008.00993.x 10. Garrote G. Repoblaciones del conejo de monte en gran escala para la conservacion del lince Iberico. In: Abstracts of the First International Wild Rabbit Seminar, 2013 Oct. 23–25. Beja (Portugal): Associacao IBERLINX, Instituto da Conservacao da Naturaleza e das Florestas, and Junta de Andalucia; 2013, p. 6. Address for correspondence: Miguel Delibes- Mateos. Instituto de Investgacion en Recursos Cinegeticos, IREC-CSIC-UCLM-JCCM, Ronda de Toledo s/n 13071 Ciudad Real, Spain; email: mdelibesmateos@gmail.com Molecular Characterization of Borrelia burgdorferi from Case of Autochthonous Lyme Arthritis To the Editor: The first Lyme borreliosis (LB) case reported to be acquired in California occurred in 1978 (1). During the past 10 years, 744 confirmed LB cases were reported in California; 419 (56.2%) were likely acquired in-state. The highest inci- dence of this disease occurs in north- ern coastal California, in locations such as Santa Cruz County (2), where habitat supports yearlong activity of the tick vector Ixodes pacificus (3,4). Existing data describe the genet- ic diversity of the LB agent Borrelia burgdorferi among ticks in Californa (5,6), but few instances of direct de- tection and genetic characterization of B. burgdorferi sensu stricto in samples from humans are documented in Cali- fornia. B. burgdorferi has been iso- lated from skin biopsy samples of 3 patients in California in whom LB was diagnosed (1). Seinost et al. genotyped strains isolated in the United States, including 7 isolates identified in Cali- fornia from skin, blood, or cerebrospi- nal fluid, but no documented exposure information was available (7). Girard et al. genotyped B. burgdorferi in 10- to 12-year-old stored serum samples collected from 22 northern California residents, some of whom were as- ymptomatic at time of collection. Of 22 PCR-positive specimens, 21 had the single laboratory type strain B31 genotype (3). A 12-year-old resident of Santa Cruz County, California, came to the emergency department of Dominican Hospital in September 2012 with a swollen, painful right knee and mildly painful right hip. The patient’s family reported that LB had been diagnosed by a local physician. Illness onset was in May 2010; symptoms consisted of recurrent knee swelling and pain last- ing several days every 4–5 months and positive serologic test results for B. burdorferi (not available). The pa- tient had not traveled outside of Cali- fornia during the preceding 6 years. In May 2011, an IgG Western blot of the patient’s serum that was processed at a commercial laboratory showed immunoreactive bands of 18, 23, 28, 30, 39, 41, 45, 58, 66, and 93 kDa. In both 2010 and 2011, the patient’s fam- ily had chosen to give the patient un- specified herbal treatments instead of antibacterial drugs. On physical examination in the emergency department, the patient’s right knee was swollen; knee flexion Emerging Infectious Diseases • www.cdc.gov/eid • Vol. 20, No. 12, December 2014

Topic: Viral Infections and Vectors
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences