During 2013-2019, Borrelia miyamotoi infection was detected in 19 US states. Infection rate was 0.5%-3.2%; of B. miyamotoi-positive ticks, 59.09% had concurrent infections. B. miyamotoi is homogeneous with 1 genotype from Ixodes scapularis ticks in northeastern and midwestern states and 1 from I. pacificus in western states.
Keywords: Borrelia miyamotoi; Ixodes pacificus; Ixodes scapularis; United States; bacteria; spirochetes; ticks; vector-borne infections.