Isolation And Genetic Characterization Of A Relapsing Fever Spirochete Isolated From Ornithodoros Puertoricensis Collected In Central Panama

Tick-borne relapsing fever (TBRF) spirochetes are likely an overlooked cause of disease in Latin America. In Panama, the pathogens were first reported to cause human disease in the early 1900s. Recent collections of Ornithodoros puertoricensis from human dwellings in Panama prompted our interest to determine whether spirochetes still circulate in the country. Ornithodoros puertoricensis ticks were collected at field sites around the City of Panama. In the laboratory, the ticks were determined to be infected with TBRF spirochetes by transmission to mice, and we report the laboratory isolation and genetic characterization of a species of TBRF spirochete from Panama. Since this was the first isolation of a species of TBRF spirochete from Central America, we propose to designate the bacteria as Borrelia puertoricensis sp. nov. This is consistent with TBRF spirochete species nomenclature from North America that are designated after their tick vector. These findings warrant further investigations to assess the threat B. puertoricensis sp. nov. may impose on human health.Author summary Tick-borne relapsing fever (TBRF) is an often misdiagnosed neglected tropical disease primarily impacting those in resource limited settings. Most species are transmitted by argasid ticks, but ixodid ticks and the human body louse are also competent vectors. Infection of TBRF spirochetes is challenging to diagnose because argasid ticks are rapid feeders and rarely spotted on the patient. Moreover, given the nonspecific manifestation of disease and poor clinical awareness, TBRF is overlooked. In Central America, TBRF was studied in the Canal Zone of Panama until the 1930s. Over the last 10 years argasid ticks have been reported to colonize human dwellings in the country but it has remained vague if the disease persists. In this study, we demonstrate the transmission of TBRF spirochetes from field collected ticks and the laboratory isolation and genetic characterization of the species. These findings suggest that TBRF spirochetes continue to circulate in Panama and should prompt health care providers to consider this disease when patients present with a fever of unknown origin. Furthermore, with the laboratory isolation of this bacteria, molecular diagnostic tools can be developed to improve epidemiological studies of TBRF spirochetes in Central America.