This page covers sexual transmission, transovarial transmission (mum tick to offspring), various biting insects, through blood transfusions & so on.
Transmission from mother to unborn child is also covered in our paediatric page.
Added Aug 2016
Occurrence of Borrelia burgdorferi s.l. in different genera of mosquitoes (Culicidae) in Central Europe
In the present study, adult as well as larval mosquitoes were collected at 42 different geographical locations throughout Germany. This is the first study, in which German mosquitoes were analyzed for the presence ofBorrelia spp.
Targeting two specific borrelial genes, flaB and ospA encoding for the subunit B of flagellin and the outer surface protein A, the results show that DNA ofBorrelia afzelii, Borrelia bavariensis and Borrelia garinii could be detected in ten Culicidae species comprising four distinct genera (Aedes, Culiseta, Culex, andOchlerotatus).
Positive samples also include adult specimens raised in the laboratory from wild-caught larvae indicating that transstadial and/or transovarial transmission might occur within a given mosquito population.
Distribution and survival of Borrelia miyamotoi in human blood components
Aaron M. Thorp,Laura Tonnett
21 December 2015
Added Mar 2015
Survival of Borrelia burgdorferi in human blood stored under blood banking conditions.
Nadelman RB, Sherer C, Mack L, Pavia CS, Wormser GP, Transfusion 1990 May;30(4):298-301.
Hematogenous dissemination of organisms occurs in many spirochetal diseases, including Lyme disease and syphilis. Although syphilis has been transmitted by transfusion, in the vast majority of cases, only fresh blood products were involved, in part because Treponema pallidum survives poorly when refrigerated in citrated blood. Because of the rising incidence of Lyme disease in certain areas, whether its causative agent, Borrelia burgdorferi, could survive under blood banking conditions was studied. Dilutions of stock cultures of two strains of B. burgdorferi were inoculated into samples of citrated red cells (RBCs). Viable spirochetes were recovered from RBCs inoculated with 10(6) organisms per mL, after refrigeration for as long as 6 weeks. It is concluded that B. burgdorferi may survive storage under blood banking conditions and that transfusion-related Lyme disease is theoretically possible.
Survival of Borrelia burgdorferiin blood products.
Baden et al Transfusion 1989 Sep;29(7):581-3. American Red Cross Blood Services, Connecticut.
To assess the potential of transmission of the disease through blood transfusion, we studied the survival of Borrelia burgdorferiin blood products under blood bank storage conditions… The organism was shown to survive in RBCs [red cells] (4 degrees C) and FFP [fresh-frozen plasma] (below -18 degrees C) for 45 days and in PCs [plateletconcentrates] (20-24 degrees C) for 6 days.
The results of this study do not exclude the possibility of transmission of Lyme disease through blood transfusion.
For more on blood transfusion head on down to: http://www.personalconsult.com/articles/bloodsupplyandlyme.html
[NB: Infection rates of 100 samples taken in 4 areas in Ireland ranged from 5–15%. The potential from transmission via blood donations must be taken seriously.]
Added Dec 2014
Lyme borreliosis: a review of data on transmission time after tick attachment
Published Date December 2014 International Jnl Gen Medicine Volume 2015:8
Approved for publication by Professor Scott Fraser
Michael J Cook- Independent researcher, Dorset, UK
Abstract: Lyme borreliosis is increasing rapidly in many parts of the world and is the most commonly occurring vector-borne disease in Europe and the USA. The disease is transmitted by ticks of the genus Ixodes. They require a blood meal at each stage of their life cycle and feed on a wide variety of wild and domestic animals as well as birds and reptiles. Transmission to humans is incidental and can occur during visits to a vector habitat, when host mammals and their associated ticks migrate into the urban environment, or when companion animals bring ticks into areas of human habitation. It is frequently stated that the risk of infection is very low if the tick is removed within 24–48 hours, with some claims that there is no risk if an attached tick is removed within 24 hours or 48 hours. A literature review has determined that in animal models, transmission can occur in <16 hours, and the minimum attachment time for transmission of infection has never been established. Mechanisms for early transmission of spirochetes have been proposed based on their presence in different organs of the tick. Studies have found systemic infection and the presence of spirochetes in the tick salivary glands prior to feeding, which could result in cases of rapid transmission. Also, there is evidence that spirochete transmission times and virulence depend upon the tick and Borrelia species. These factors support anecdotal evidence that Borrelia infection can occur in humans within a short time after tick attachment.
Added Aug 2014
24 Hours Of Attachment Is An Estimate – Not a Safety Blanket
Transmission by Contact via Feces, urine or Tick-excretes – can Borrelia burgdorferi enter through intact mucous membranes?
A collection of 8 Lyme transmission studies on one page!
Discussion on Borrelia in other insects than ticks
Lyme Disease May Be Sexually Transmitted, Study Suggests
Fox News – Transmission of Lyme Under Debate
Ticks and Biting Insects Infected with the Etiologic Agent of Lyme Disease, Borrelia burgdorferi
LOUIS A. MAGNARELLI* AND JOHN F. ANDERSON / JOURNAL OF CLINICAL MICROBIOLOGY, Aug. 1988,
Department of Entomology, The Connecticut Agricultural Experiment Station, P.O. Box 1106, New Haven,
Connecticut 06504 Received 11 March 1988/Accepted 6 May 1988
Groups of 113 field-collected mosquitoes ofAedes canadensis and 43 Aedes stimulans were placed in cages with uninfected Syrian hamsters. Of these, Il females of both species contained B. burgdorferi and had fed fully or partially from the hamsters. No spirochetes were isolated from the hamsters, but antibodies were produced in one test animal.
Full paper available at: http://jcm.asm.org/content/26/8/1482.full.pdf
Hard Tick Factors Implicated in Pathogen Transmission
Xiang Ye Liu, Sarah I. Bonnet*
USC INRA Bartonella-tiques, UMR BIPAR ENVA-ANSES, Maisons-Alfort, France
Ticks are the most common arthropod vector, after mosquitoes, and are capable of transmitting the greatest variety of pathogens. For both humans and animals, the worldwide emergence or re-emergence of tick-borne disease is becoming increasingly problematic. Despite being such an important issue, our knowledge of pathogen transmission by ticks is incomplete. Several recent studies, reviewed here, have reported that the expression of some tick factors can be modulated in response to pathogen infection, and that some of these factors can impact on the pathogenic life cycle. Delineating the specific tick factors required for tick-borne pathogen transmission should lead to new strategies in the disruption of pathogen life cycles to combat emerging tick-borne disease.
Added Feb 2014
Can you be a silent carrier?
Latent, dormant, subclinical, or asymptomatic Lyme disease
An Annotated Bibliography
Lyme disease is a serious bacterial infection caused by a tick bite and affects humans and animals.
This page contains citations and highlighted extracts for medical and scientific articles from the National Institutes of Health (NIH), National Library of Medicine (NLM) MEDLINE database about latent, dormant, subclinical, or asymptomatic Lyme disease. Citations are sorted by date within categories.(please note that some links are now broken within page however by scrolling further down within the site you’ll see many studies listed with key findings in bold…)
Can Lyme be passed from mother tick to her eggs?
This is another debate in the Lyme world, some studies show low evidence of larval ticks being infected transovarially, other studies find high numbers of infected larval ticks & eggs.
A good compendium of studies with key findings in blue available at:
Is Lyme Disease Contagious? Clues Hint That It May Be A Sexually Transmitted Disease
By Lizette Borreli | Jan 27, 2014 12:47 PM EDT (Medical Daily)
[NB: Sexual transmission maybe tied to vaginal fluid..Eva Sapi has confirmed that a larger study is being instigated]
The control subjects were found to test negative for the bacterium in semen samples or vaginal secretions, as expected by the researchers. The researchers found traces of B. burgdorferi in the vaginal secretions of all women with Lyme disease. In contrast, approximately half of the men with the disease tested positive for the bacterium in semen samples. In addition, one of the heterosexual couples with Lyme disease were found to have identical strains of the bacterium in their genital secretions.
Added November 2013
2 studies of mosquitoes:
Ticks and mosquitoes as vectors of Borrelia burgdorferi & Isolation of Borrelia afzelii from overwintering Culex pipiens biotype molestus mosquitoes available at: http://www.lyme.ws/ticks-and-mosquitoes-as-vectors-of-borrelia-burgdorferi/
Updated Aug 2014: The link above is currently broken however a study called Ticks and mosquitoes as vectors of Borrelia burgdorferi s. l. in the forested areas of Szczecin is available at: http://www.ncbi.nlm.nih.gov/pubmed/18274258
The aim of the study was to determine the infection level of adult forms and larvae of ticks and mosquitoes with Borrelia burgdorferi in the forested areas of Szczecin. A total of 1699 ticks Ixodes ricinus, including 1422 nymphs, 277 adult forms and 2862 mosquito females representing the genera Aedes (89.6%) and Culex (10.4%) were collected between the years 2004 and 2005. A further 3746 larvae and 1596 pupae of Culex pipiens pipiens were colleted from water bodies. Borrelia burgdorferi s. l. was detected in the arthropods by the method of indirect immunofluorescence assay (IFA). A positive immunological reaction was detected in 16.6% of the adult forms and in 16.5% of the nymphs of Ixodes ricinus. Spirochetes were also detected in 1.7% of mosquito females, 3.2% of larvae and in 1.6% of pupae of Culex pipiens pipiens. The results of the present study confirm that contact with ticks constitutes the main risk of contracting Lyme disease, although mosquitoes play a role as vectors as well.
Isolation of Borrelia afzelii from overwintering Culex pipiens biotype molestus mosquitoes (2006)
A total of 662 samples (winter period: 469; summer period: 193 specimens) of female mosquitoes of the genus Culex, Aedes and Anopheles were collected during the period March 2000-April 2001 from the locality of Vysoke Myto (Eastern Bohemia, Czech Republic). They were examined by dark field microscopy for the presence of spirochetes. The motile spirochetes were observed in 4.2 % of all species of investigated mosquitoes. One spirochetal strain out of the 8 isolation attempts (BRZ14) was obtained (cultivation rate was 12.5 %) and the spirochetal strain was then successfully cultivated and identified using PCR for the presence of Borrelia burgdorferi s.l., and subsequently with the RFLP as genomospecies Borrelia afzelii. This strain was derived from overwintering Culex (Culex) pipiens biotype molestus female mosquitoe. This is apparently one of the sporadic cases of the occurrence of pathogenic borreliae in haematophagous arthropods, other than Ixodes ricinus complex ticks.
Isolation of Borrelia afzelii from overwintering Culex pipiens biotype molestus mosquitoes (1999)
During the years 1995-1996, a total of 1,743 overwintering Culex pipiens biotype molestus female mosquitoes were tested for the presence of spirochetes in several localities in South Moravia, Czech Republic.The spirochetes were observed in 5% of the mosquitoes investigated. One of the five isolated strains of spirochetes (BR-84) was identified as Borrelia afzelii. The potential role of mosquitoes in the ecology and epidemiology of Lyme disease (LD) borreliae should be further investigated.
Added 1st August 2013
Over half of respondents with EM claimed tick was on them less than 24 hours!
Added 26th June 2012
Novel Animal Reservoir for Group of Tick-Borne Diseases Discovered — And It Lives in Your Backyard
ScienceDaily (June 23, 2012)
— A team of scientists at Washington University in St. Louis has been keeping a wary eye on emerging tick-borne diseases in Missouri for the past dozen years, and they have just nailed down another part of the story.
They knew from earlier work that the animal reservoirs for the diseases included white-tailed deer, wild turkey and a species in the squirrel famiiy, but the DNA assay they had used wasn’t sensitive enough to identify the species.
Squirrels belong to a large family called the Sciuridae, which includes chipmunks, fox squirrels, red squirrels, flying squirrels, ground hogs and prairie dogs.
In the May issue of the Journal of Medical Entomology the scientists, led by Robert E. Thach, PhD, professor of biology in Arts & Sciences, report that a more sensitive assay has allowed them to identify the major species in question as the eastern gray squirrel.
More at: http://www.sciencedaily.com/releases/2012/06/120623094409.htm
Transmission rate of Bb from bites of infected ticks
Many articles on Lyme, particularly by government agencies site 24-48 hours of tick attachment needed for Lyme transmission. The web link below sites a few studies where transmission occurred in far less time. In some studies they suggested that the bacteria can be carried in the tick’s salivary glands and as they pump saliva into you for an anesthetic effect that could be one way to transmit disease. Ticks also use a cement plug to keep their mouth parts attached just under the skin and one article identifies this as being the cause of transmission. All interesting stuff!
Investigations on the mode and dynamics of transmission and infectivity of Borrelia burgdorferi sensu stricto and Borrelia afzelii in Ixodes ricinus ticks.
Crippa M, Rais O, Gern L.
Institut de Zoologie, University of Neuchâtel, Switzerland.
Borrelia burgdorferi sensu lato (sl), the agent of Lyme disease, is transmitted to the host during the blood meal of Ixodes ticks. In most unfed ticks, spirochetes are present in the midgut and migrate during blood feeding to the salivary glands, from which they are transmitted to the host via saliva. In the present study, the efficiency of Ixodes ricinus ticks to transmit B. afzelii and B. burgdorferi sensu stricto (ss) and their infectivity for mice were examined in relation to the duration of the blood meal. In addition, we investigated whether these two Borrelia species can penetrate intact skin.
Three modes of infection of mice were studied: tick-bite infection, inoculation of tick homogenates, and transcutaneous infection by topical application of tick homogenates on mouse skin.
Transmission of B. burgdorferi sl from I. ricinus nymphs to mouse increased with duration of tick attachment. B. afzelii-infected ticks start to transmit infection earlier (< or = 48 h) than B. burgdorferi ss-infected ticks. As previously shown for B. burgdorferi ss in Ixodes scapularis, B. burgdorferi ss and B. afzelii in unfed I. ricinus were noninfectious for mice when tick homogenates were inoculated. However, the inoculation of homogenates of ticks fed for 24 h readily produced infection in mice. Therefore, B. burgdorferi ss and B. afzelii spirochetes are potentially infectious in the tick before natural transmission can occur.
None of the mice (n = 33) became infected by transcutaneous transmission when tick homogenates were applied on mouse skin, showing that B. burgdorferi ss and B. afzelii are unable to penetrate intact skin, in contrast to relapsing fever spirochetes.
This study also shows that B. afzelii is transmitted by I. ricinus to the host earlier than B. burgdorferi ss and that I. ricinus seems to be a more efficient vector of B. afzelii than B. burgdorferi ss.
Increase Evidence Of Mosquito / Spirochete Associations
Willy Burgdorfer, PhD, MD (Hon)
Rocky Mountain Laboratories
National Institutes of Health, National Institute of Allergy and Infectious Diseases
The recent demonstration and isolation of spirochetes (including the Lyme disease agent, Borrelia afzelii) in and from Aedes and Culex mosquitoes in southern Moravia (Czech Republic) promoted this short review of literature pertaining to the association of spirochetes with mosquitoes.
Reports as early as 1904 describe the presence of spirochetes in intestinal tracts of larval mosquitoes as well as in malpighian tubules and salivary glands of adult Culex, Anopheles and Aedes mosquitoes. Yet, there is no information as to the ability of these insects to transmit spirochetes by bite. An exception is a report on the successful transmission of Borrelia anserina by experimentally infected Aedes aegypti. Similar experimental infection and transmission studies of the Lyme disease agent Borrelia burgdorferi sensu stricto in three species of mosquitoes (Ae. aegypti, Ae. atropalpus, Ae. triseriatus) showed the duration of spirochetal infections in the intestinal tracts of these insects to be ephemeral and not involving salivary gland tissues. In contrast are the recent reports from southern Moravia where over-wintering Aedes and Culex have been found naturally infected with spirochetes. One strain isolated from Ae. vexans was identified as B. afzelii, two other strains from C. pipiens molestus appeared to be new hitherto undescribed spirochetes. Studies are in progress to determine whether these spirochetes produce in their mosquito vectors systemic infections including the tissues of salivary glands from where they could be transmitted via saliva during feeding on animal hosts and possibly humans.
http://www.lyme.org/conferences/98_abstract.html (link now broken but kept for informational purposes)
Tick saliva accelerates the proliferation of Borrelia bacteria
“Recent studies by the Faculty of Biological Sciences, University of South Bohemia and Institute of Parasitology, provide direct evidence that tick saliva accelerates the proliferation of Borrelia bacteria. This evidence negates previous advice that a tick needs to be attached for over 24 hours for disease transmission to occur.”
NB Link is now broken but have kept for observation purposes.
BADA also have a disease transmission page containing video & pictures at: http://www.bada-uk.org/disease-transmission
Can Lyme infection be transmitted via blood banks?
This is a letter that PJ wrote to the IDSA regarding Lyme potentially being transmitted through blood banks. Well worth a read:
Can flies & mosquitoes transmit Lyme?
W. Burgdorfer in 1984: Yale J Biol Med. 1984 Jul–Aug; 57(4): 515–520.
“In view of the unusual behavior (limited distribution, loss of infection intensity) of the spirochetes in ticks, the possibility that other hematophagous arthropods, such as biting flies, gnats, and mosquitoes, may play a role as mechanical vectors of ECM and Lyme disease cannot be ruled out.”
What happens when a tick attaches?
by Tom Grier
This is the essence of the pathogenisis of Lyme disease: if you understand this concept of infection, you begin to understand why the conservative viewpoint of Lyme is causing latent morbidity and mortality.
In several mammal studies in the late 1980s, it was shown in many species including dogs that within hours of tick attachment that the Lyme organism is with every beat of the heart circulating through the entire body. The spirochete’s motility allows it to position itself into the cracks and folds of a blood vessel wall.
Borrelia burgdorferi has a tropism or an attraction to attach to the endothelial cells lining blood vessels. Once the bacteria has attached it traps tissue plasminogen that converts to plasmin and this begins the process of inflammation. This irritation causes the endothelial cells to release digestive enzymes such as basement membrane laminase, hyaluronidase, lipases, proteases. White blood cells join in at the site releasing Metalo-Matrix- Protease that facilitates cell penetration, and Tumor Necrosis Factor Alpha, and Il-1, Il-6 and TGF beta, all which play a role in cell communications and begin inflammatory cascades to begin.
The net result is within 24-48 hours we can measure the breakdown of the blood-brain- barrier in dogs that peaks at 48 hours and lasts for up to 14 days! So are we really going to say that a tick has to be attached 48 hours? This animal model suggests that the infection is potentially already established within the brain. This study was done by tagging normal blood albumin with radioactive Iodine and tracking it into the CSF of the dogs. (1989 Immunological Methods of Borreliosis Cold Spring Harbor)
If the Borrelia bacteria which as a family has been known to be neurogenic and deadly since 1910 can penetrate blood vessels, then why do physicians who should know better still make public statements in the media that Lyme disease is not transmitted transplacentally to the fetus during pregnancy. Nine published fetal autopsies since 1987 suggest otherwise, so what is their agenda for pretending to be ignorant of the facts?
The heart and soul of the mechanism of infection, or the pathogenisis of Borrelia bacteria that cause Relapsing Fever and Lyme Disease is its ability to attach to the lining of blood vessels and cause gaps or holes to appear between the endothelial cells.
The endothelial cells themselves release digestive substances, as well as our own white blood cells releasing blood-born immune factors such as tissue plasminogen, TNF-alpha, IL-1, Il-6, histamines, vaso-active amines and MMP-9 that facilitates cell penetration through any and all blood vessels, but especially important is the immediate transit of Borrelia burgdorferi through the blood-brain-barrier.
Animal models including dogs and primates show conclusively that this is not just a random occurrence, but rather a very specific mechanism that facilitates both the immediate and long-term survival of Borrelia within mammalian systems. In dog-models, the uninfected dog’s blood protein albumin was tagged with radioactive Iodine, and then traced using radio-detection of entering the brain and spinal-fluid. After infected ticks were allowed to feed on the dogs, this “leaky-brain-effect” took less than 24-48 hours to reach its full potential.
We can measure and observe this leaky-brain-effect in dogs, hamsters, rabbits, and primates within hours, and we can see and detect in many other animal models including guinea pigs, mice, hamsters, and rabbits the actual transit of Borrelia into the brain of these animals within days of tick-bite, yet our own USA health-care experts are saying without equivocation that infected ticks have to be attached for at least 36-48 hours (YALE Medical Report, IDSA-Lyme Treatment Guidelines)
Why is there such an absolute dictatorship in our guidelines when we have direct animal studies since 1989 that suggest that not only does Borrelia bacteria penetrate blood vessels and enter the brain, but once the blood-brain-barrier closes up 10-14 days after initial infection; the sequestered bacterial infection within the brain is undetectable by serology tests.
Our current serology tests that detect antibodies to the Lyme bacteria; require at least 4-6 weeks after exposure to produce significant antibodies to the Lyme bacterium. By then the infection can be resting dormant and quiescently within the host’s brain, undetected, undetectable, and creating changes within the brain that are subtle and perhaps for awhile negligible.
Lyme Disease Transmitted by a Biting Fly
N Engl J Med 1990 Jun 14;322(24):1752
To the Editor:
Lyme disese, first described by Steere et al. in 1977,1 was identified as a disease transmitted by the bite of ixodes ticks.2 Burgdorfer, Barbour, and colleagues then isolated the infectious agent, a spirochete now known as Borrelia burgdorferi.3 the spirochete has been shown to be transmitted by a variety of ixodes ticks, including Ixodes dammini, I. ricinus, I. pacificus, and I. persulcatus.4 B. burgdorferi has been identified in biting flies, and there has been anecdotal mention of possible transmission of B. burgdorferi by such flies. 5,6 This repost describes a case of Lyme disease transmitted by a fly bite.
On July 10, 1989, while jogging with no shirt on, a 42-year-old man from Old Lyme, Connecticut, an area in which Lyme disease is endemic, was bothered by a large fly that he believed to be either a deerfly or a horsefly. After swatting at it unsuccessfully, he was bitten by the fly several times on the right side of the chest. The bites were acutely painful. The area around the bites was swollen for one to two days; the swelling then subsided. The patient was not aware of any tick bites in teh previous three months. On July 23, he presented with classic erythema migrans surrounding the bite area, headache, chills, fever, myalgias, arthralgias, and fatigue.
The patient had a temperature of 37.2°C and a pulse of 76 per minute. Examination disclosed a 16-cm by 11-cm rash (erythema migrans) on the right side of the chest, with several small papular areas in it’s center consistent with fly bites No regional adenopathy was present, and no cardiac, joint, or neurologic abnormalities were found. A diagnosis of Lyme disease was made, and treatment was initiated with amoxicillin (500 mg three times a day) and probenecid (500 mg three times a day) for 10 days. On the first night after treatment the patient had a Jarisch-Herxheimer reaction, with a fever and worsening of his headache and myalgias. At his 10- and 30- day follow-up visits he was asymptomatic, and has remained well since.
Antibody titres to B. burgdorferi were determined by enzyme-linked immunosorbent assays in the acute phase and at the 10- and 30- day follow-up visits. These analyses confirmed a more than four-fold rise in antibodies to B. burgdorferi (Table 1). Results of other laboratory tests were within normal limits.
The patient was bitten by a biting fly (an act he both saw and felt) and subsequently presented with Lyme disease, with erthema migrans at the site of the bite. Serologic testing confirmed a more than fourfold rise in antibodies to B. burgdorferi. In contrast to the painless bite of I. dammini, the bite of flies is painful and not likely to be overlooked by the patient as a means of transmission of Lyme disease. I conclude that although in most cases Lyme disease is transmitted by the bite of ixodes ticks, it may rarely be transmitted by biting flies.
Steven W. Luger, M.D.
8 Davis Rd
Old Lyme, CT 06333
Anti-alarmin effect of tick saliva during the transmission of Lyme disease
Infect. Immun. doi:10.1128/IAI.00482-10
Copyright (c) 2010, American Society for Microbiology and/or the Listed Authors/Institutions. All Rights Reserved.
Claire Marchal, Frederic Schramm, Aurélie Kern, Benjamin J. Luft, Xiaohua Yang, Tim Schuijt, Joppe Hovius, Benoît Jaulhac*, and Nathalie Boulanger
..We conclude that tick saliva affects the chemotactic properties of chemokines and AMPs on immune cells and has an anti-alarmin effect on human primary keratinocytes. Alarmins are mediators that mobilize and activate antigen-presenting cells. Inhibition of cutaneous innate immunity and of the migration of immune cells to the site of the tick bite ensures a favorable environment for Borrelia. The bacterium can then multiply locally and, subsequently, disseminate to the target organs, including joints, heart, and central nervous system.
Lyme disease followed by human granulocytic anaplasmosis in a kidney transplant recipient.
Assi MA, Yao JD, Walker RC.
Transpl Infect Dis. 2007 Mar;9(1):66-72.
Division of Infectious Diseases, Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, MN 55905-0002, USA.
We report the case of a kidney transplant recipient who developed Lyme disease, followed by human granulocytic anaplasmosis (HGA) 3 years later. A review of all previously published cases of Lyme disease (3 cases), HGA (5 cases), and human monocytic ehrlichiosis (HME) (5 cases) in transplant recipients is presented. Manifestations of the cases reviewed were similar to those of non-transplant patients. There appeared to be no obvious correlation between immunosuppression and the occurrence of the illness in the transplant recipients. Serologic testing failed to make a diagnosis in 1 patient with HME in the literature and in our patient with HGA, but molecular tests established the diagnosis in both cases. Tandem infection was observed in 1 patient with two episodes of HME 2 years apart. A high index of suspicion for tick-borne illnesses and appropriate prevention measures are needed for transplant patients with epidemiologic risk factors.
PMID: 17313478 [PubMed – indexed for MEDLINE]
Risk of infection with Borrelia burgdorferi sensu lato for a host in relation to the duration of nymphal Ixodes ricinus feeding and the method of tick removal.
Zentralbl Bakteriol. 1998 Jan;287(1-2):41-52.
Kahl O, Janetzki-Mittmann C, Gray JS, Jonas R, Stein J, de Boer R.
Institute of Zoology, Free University of Berlin, Germany.
The objectives of the present study were to investigate the risk of B. burgdorferi s.1. (Bb)-transmission by I. ricinus-nymphs to a host (i) after different periods of feeding, and (ii) with regard to the particular method of tick removal. On each of 72 Mongolian gerbils 3 tick nymphs taken from a highly infected batch were allowed to feed in a small capsule. Feeding ticks were removed 16.7, 28.9, 47.0, and 65.2 hrs post-attachment. In each of these 4 groups 3 sub-groups with 6 gerbils each were deticked by (a) pulling ticks out with forceps without any pretreatment, (b) pulling ticks out after 3 min of intensive squeezing, and (c) applying nail polish to ticks 1.1 hrs before removal. The infection status in each gerbil was subsequently determined by larval xenodiagnosis. All gerbils with ticks removed > or = 47 hrs post-attachment were found to be infected. After 16.7 hrs as well as after 28.9 hrs of tick feeding, approximately 50% of the gerbils had acquired a transmissible infection, thus Bb-transmission to a host may even occur in the early phases of I. ricinus feeding. There is no evidence from this study that the tick removal method used has any significant influence on a host’s Bb-infection risk.
PMID: 9532263 [PubMed – indexed for MEDLINE]
Lyme borreliosis in Europe: influences of climate and climate change, epidemiology, ecology and adaptation measures
By: Elisabet Lindgren Thomas G.T. Jaenson
3.4. Pathogen circulation in nature
Once a tick has become infected with spirochetes it will harbour the pathogens for the rest of its life. Transmission of pathogens often takes place between one and three days after an infected tick has attached itself to a host/human (Kahl et al., 1998). Thus, if a tick is detected and immediately removed after attachment the risk of infection in humans is reduced substantially.
Little is known about the duration of borrelia infection in vertebrate hosts. In England and Wales pheasants are important reservoirs and may be infective for ticks for as long as three months (Kurtenbach et al., 1998a). At present only small rodents — apart from the ticks themselves — are known to remain infected during the winter period (Humair et al., 1999). The transmission of B. burgdorferi s.l. in nature is less sensitive to seasonal variations in tick activity patterns than the TBE virus transmission cycle (Randolph, 2001) because of the longer period that the reservoir hosts stay infectious with B. burgdorferi s.l.
Borrelia spirochetes may be transferred directly from the female tick to its offspring, but such vertical transmission is rare (e.g. Mejlon & Jaenson, 1993; Gray et al., 1998a; Humair & Gern, 2000). In general, less than 1% of host-seeking larvae are infected, compared with between 10% and 30% of the nymphs and between 15% and 40% of adults (Aeschlimann et al., 1986; Jaenson, 1991; Mejlon & Jaenson 1993; Gray et al., 1998a). The majority of the different tick stages become infected when feeding on blood from an infective reservoir animal. The skin of some host species (including some reservoir-incompetent hosts, such as sheep) can constitute an interface for the transmission of spirochetes between infected and non-infected ticks that are cofeeding closely together (Randolph et al., 1996; Ogden et al., 1997). However, six times as many ticks acquire infection when feeding on infected mice as when co-feeding with infected ticks and only 1 out of 100 larvae appears to acquire spirochetal infection when co-feeding with infected nymphs (Richter et al., 2002).
The tick is attached to the host for several days during feeding. This allows the tick to be carried passively into new locations by the host it is attached to. Small mammals such as rodents have rather limited territories. Larger animals such as roe deer normally move around within a range of between 50 and 100 hectares (Cederlund & Liberg, 1995), while birds may deposit ticks far from their original habitat. Birds are often passive carriers of ticks infected with B. burgdorferi s.l. (Olsen et al., 1995). Therefore, migrating birds play a role in the introduction of pathogens into new locations along their migratory routes. In addition migratory birds have recently been found to be able to carry LB as a latent infection for several months, and this infection can be reactivated and passed on to ticks as a result of the stress the birds experience during migration (Gylfe et al., 2000).
The dispersal of borrelia pathogens by birds into the European Region may occur along the migrating routes northward/southward in Europe, from Africa in the south and along the western-eastern routes from Eurasia, depending on the bird species. Even though birds account for most of the long-range spread of ticks and pathogens this rarely leads to any major new colonization of ticks or to LB outbreaks in previously nonendemic areas (Jaenson et al., 1994), unless local ecological conditions have been altered, either by land use/land cover changes or climate change (Lindgren, forthcoming). However, transport of ticks and pathogens by migratory birds does have an impact on tick abundance and, in the case of B. valaisiana and B. garinii (see Table 5 in Section 7.1), on the infectivity in areas that are already LB endemic and/or where suitable ecological conditions are present.
Borrelia burgdorferi Population Kinetics and Selected Gene Expression at the Host-Vector Interface
Infect Immun. 2002 July; 70(7): 3382–3388.
Copyright © 2002, American Society for Microbiology
Emir Hodzic, Sunlian Feng, Kimberly J. Freet, Dori L. Borjesson, and Stephen W. Barthold*
As shown by other workers (12) and in the present study, feeding stimulates spirochetes to rapidly multiply within ticks, as observed in infected ticks during feeding. Our results indicate that feeding ticks acquire spirochetes within 1 day after attachment to infected hosts and that hosts acquire spirochetes within 1 day after attachment of infected ticks. Other workers have shown that there is transmission within 1 day, but at a very low rate (36). The differences are likely to be due to spirochete isolation and experimental variables, but the data demonstrate that transmission can be quite rapid.
Distance Learning Module on Lyme Disease incs strains & transmission by Inst of Tropical Medicine Antwerp
European ticks successfully inoculate the host much more quickly and more often than their American counterparts. In Europe transmission is thought to take place in 50% of cases if the tick has been present for 16 hours.
Clinical evidence for rapid transmission of Lyme disease following a tickbite☆
Eleanor D. Hynotea, Phyllis C. Mervinea, Raphael B. Stricker , a,
a International Lyme and Associated Diseases Society1, P.O. Box 341461, Bethesda, MD 20827-1461, USA
Received 31 August 2011; Accepted 6 October 2011. Available online 20 November 2011.
Lyme disease transmission to humans by Ixodes ticks is thought to require at least 36–48 h of tick attachment. We describe 3 cases in which transmission of Borrelia burgdorferi, the spirochetal agent of Lyme disease, appears to have occurred in less than 24 h based on the degree of tick engorgement, clinical signs of acute infection, and immunologic evidence of acute Lyme disease. Health care providers and individuals exposed to ticks should be aware that transmission of Lyme disease may occur more rapidly than animal models suggest. A diagnosis of Lyme disease should not be ruled out based on a short tick attachment time in a subject with clinical evidence of B. burgdorferi infection.
Sexual Transmission of LD
Lyme has been likened to Syphilis. They are both corkscrew shaped bacteria (called spirochetes) , both can evade treatment and the immune system, both can change into a cyst like structure with a protective bio film coating, both can cause multiple symptoms throughout the body, both can go through various stages from primary to late stage and chronic and both can be passed on through the placenta. Alarmingly it seems that their similarities don’t end there – some article have come out linking the rise of Lyme disease across the world, not only with increasing tick habitation but also with possible sexual transmission. As we come across articles on the subject we will post them here..
Lyme Disease On The Rise – Sexual Transmission?
(extracts below – full text in link above)
When the CDC reports that Lyme is on the rise, assuming they had accurate statistics which is debatable, it is time to speak out.
The Canadian Lyme Disease Foundation has published the following abstract by Dr. Gregory Bach, Do.O.P.C. from Pennsylvania back in 2001. It begs the question of why more studies like this have been withheld from the public:
RECOVERY OF LYME SPIROCHETES BY PCR IN SEMEN SAMPLES OF PREVIOUSLY DIAGNOSED LYME DISEASE PATIENTS
Lyme disease, being a spirochete with pathology similar to syphilis, is often found difficult to treat due to the spirochete invading sanctuary sites and displaying pleo-morphic characteristics such as a cyst (L-form). Because a significant portion of sexually active couples present to my office with Lyme disease, with only one partner having a history of tick exposure, the question of possible secondary (sexual)vector of transmission for the spirochete warrants inquiry.
Additionally, sexually active couples seem to have a marked propensity for antibiotic failure raising the question of sexually active couples re-infecting themselves through intimate contact.
Lyme spirochetes/DNA have been recovered from stored animal semen. Recovery of spirochete DNA from nursing mother’s breast milk and umbilical cord blood by PCR (confirmed by culture/microscopy), have been found in samples provided to my office.
Surprisingly, initial laboratory testing of semen samples provided by male Lyme patients (positive by western blot/PCR in blood) and the male sexual partner of a Lyme infected female patient were positive approximately 40% of the time.
PCR recovery of Lyme DNA nucleotide sequences with microscopic confirmation of semen samples yielded positive results in 14/32 Lyme patients (13 male semen samples and 1 vaginal pap).
ALL positive semen/vaginal samples in patients with known sexual partners resulted in positive Lyme titers/PCR in their sexual partners. 3/4 positive semen patients had no or unknown sexual partners to be tested. These preliminary findings warrant further study. Current a statistical design study to evaluate the possibility of sexual transition of the spirochete is being undertaken.
Our laboratory studies confirm the existence of Lyme spirochetes in semen/vaginal secretions. Whether or not further clinical studies with a larger statistical group will support the hypothesis of sexual transmission remains to be seen. A retrospective clinical study is also underway.
We are reviewing the medical records, collecting semen samples of patients who were previously diagnosed with current and previously treated Lyme disease are being asked to provide semen,pap and blood samples for extensive laboratory testing.
With the initially impressive data, we feel the subsequent statistical sudy on the sexual transmission of the Lyme spirochete will illuminate a much broader spectrum of public health concerns associated with the disease than the originally accepted tick borne vector.”
Also, according to the Serano Group (http://www.seranogroup.org/index.php/site/entry/why_no_ticks/), as far back as 1986 the National Institute of Health (NIH), working with other researchers, put uninfected mice in a cage with Bb infected mice. All of the uninfected mice had evidence of Bb infection 42 days later.
And it is well established that Bb is found in urine. Willy Burgdorfer, the discoverer of Borrelia burgdorferi, unfortunately got Lyme borreliosis when urine from an infected rabbit splashed into his eye. As with blood transfusions, not enough research has been done on transmission by other body fluids.
The Serano Group also reports that in April, 2001, Dr. Gregory Bach presented a paper at the International Scientific Conference on Lyme Disease showing that in 42 tested Lyme borreliosis patients, 14 had DNA evidence of Bb in semen or vaginal fluids.