Emerging Tickborne Disease Hard Tick Relapsing Fever HTRFBorrelia miyamotoi Surveillance in New Jersey Continuing Medical Education

Updated:
January 21, 2026
Published:
August 28, 2023

What You Need To Know

  • B. miyamotoi is an agent of hard tick relapsing fever (HTRF), although resulting illness has also been referred to as B. miyamotoi disease.
  • Between 2018-2022, NJDOH received 162 reports of B. miyamotoi in residents from 14 counties. While the number of reports has dropped significantly between 2019-2022, the percentage of reports meeting the surveillance case definition has increased.
  • Characteristics of Hard Tick Relapsing Fever Caused by Borrelia miyamotoi, United States, 2013–2019 is available for review and no-cost continuing medical education (CME) credits via the Emerging Infectious Diseases journal. This article summarizes clinical information on 300 HTRF cases reported from 9 states (including New Jersey) between 2013-2019.
Case investigations show that nonspecific symptoms, including fever and headache were common and rash was relatively uncommon. Most cases of HTRF had symptom onset between June and September. Healthcare providers should consider B. miyamotoi infection in patients with non-specific febrile illness during summer months. Specific laboratory diagnosis of B. miyamotoi infection is achieved through PCR detection of B. miyamotoi DNA, which is available at several commercial laboratories. While serological testing can also be used, it lacks specificity and may cross-react with other common bacterial pathogens.

For More Information

For more information, please contact the NJDOH Communicable Disease Service, Vector-borne Disease Team, (609) 826-5964.