Lyme Disease Transmission: Can It Spread from Person to Person?

•June 16, 2019 • Leave a Comment

Excerpted from Healthline: (06/11/2019)

Can you catch Lyme disease from someone else? The short answer is no. There’s no direct evidence that Lyme disease is contagious. The exception is pregnant women, who can transmit it to their fetus.

Lyme disease is a systemic infection caused by spirochete bacteria transmitted by black-legged deer ticks. The corkscrew-shaped bacteria, Borrelia burgdorferi, are similar to the spirochete bacteria that cause syphilis.

Lyme disease can become debilitating for some people and life-threatening if it isn’t treated.

The Centers for Disease Control and Prevention (CDC)Trusted Source estimates that 300,000 people in the United States are diagnosed with Lyme each year. But many cases may go unreported. Other studies suggest that the incidence of Lyme may be as high as 1 million cases per year.

Diagnosis is challenging because Lyme symptoms mimic those of many other diseases.

Historical facts about Lyme
Lyme takes its name from the Connecticut town where several children developed what looked like rheumatoid arthritis in the 1970s. The culprit was thought to be a tick bite.
In 1982, scientist Willy Burgdorfer identified the bacterial causeTrusted Source of the illness. The tick-borne bacteria, Borrelia burgdorferi, is named after him.
Lyme isn’t a new disease. Lyme-type spirochetes were found in the Tyrolean IcemanTrusted Source, a 5,300-year-old well-preserved body discovered in the Alps in 1991.
What’s the most common way to get Lyme?
Blacklegged deer ticks infected with Borrelia burgdorferi transmit the Lyme bacteria when they bite. The ticks, Ixodes scapularis (Ixodes pacificus on the West Coast), can also transmit other disease-causing bacteria, viruses, and parasites. These are called coinfections.

A tick requires a blood meal at each stage of its life — as larvae, nymphs, and adults. Ticks normally feed on animals, ground-feeding birds, or reptiles. Humans are a secondary blood source.tick

Most bites to humans are from tick nymphs, which are the size of poppy seeds. It’s hard to spot them, even on open skin. The prime seasons for human tick bites are late spring and summer.

As an infected tick feeds on you, it injects spirochetes into your blood. Animal researchTrusted Source has shown that the severity (virulence) of infection varies, depending on whether the spirochetes are from the tick’s salivary glands or the tick’s midgut. In this animal research, infection required 14 times more midgut spirochetes than saliva spirochetes.

Depending on the tick’s bacterial virulence, you could be infected with Lyme within 24 hoursTrusted Source of the tick bite.

Can you get Lyme from bodily fluids?
Lyme bacteria may be found in bodily fluids, such as:

breast milk
But there’s no hard evidence that Lyme spreads from person to person via contact with bodily fluids. So don’t worry about kissing someone with Lyme.

Can you get Lyme from sexual transmission?
There’s no direct evidence that Lyme is sexually transmitted by humans. Lyme experts are divided about the possibility.

“The evidence for sexual transmission that I’ve seen is very weak and certainly not conclusive in any scientific sense,” Dr. Elizabeth Maloney told Healthline. Maloney is president of the Partnership for Tick-Borne Diseases Education.

Dr. Sam Donta, another Lyme researcher, agreed.

On the other hand, Lyme researcher Dr. Raphael Stricker told Healthline, “There’s no reason why the Lyme spirochete can’t be sexually transmitted by human beings. How commonly it occurs, or how difficult it is, we don’t know.”

Stricker has called for a “Manhattan Project” approach to Lyme, including more research.

Indirect studies of human transmission are suggestiveTrusted Source, but not definitive. A few animal studies of sexual transmission of the Lyme spirochete have shown that it does occur in some cases.

It’s not ethical to test sexual transmission by deliberately infecting humans, as was done with syphilis in the past. (The syphilis spirochete is transmitted sexually.)

A 2014 studyTrusted Source found live Lyme spirochetes in semen and vaginal secretions of people with documented Lyme. But this doesn’t necessarily mean there are enough spirochetes to spread infection.

Can you get Lyme from a blood transfusion?
There are no documented cases of Lyme transmission via a blood transfusion.

But the Lyme spirochete Borrelia burgdorferi has been isolated from human blood, and an older 1990 research studyTrusted Source found that Lyme spirochetes could survive the normal blood bank storage procedures. For this reason, the CDCTrusted Source recommends that people being treated for Lyme shouldn’t donate blood.

On the other hand, there have been more than 30 cases of transfusion-transmitted babesiosis, a parasite coinfection of the same black-legged tick that transmits Lyme.

Can Lyme be transmitted during pregnancy?
A pregnant woman with untreated Lyme can transmit the infectionTrusted Source to the fetus. But if they receive adequate treatment for Lyme, adverse effects are unlikely.

A 2009 studyTrusted Source of 66 pregnant women found that untreated women had a significantly higher risk of adverse pregnancy outcomes.

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Antibody Shows Promise In Fight Against Lyme Disease, UMass Researcher Says

•May 5, 2019 • Leave a Comment

Excerpted from WBUR: (05/03/2019)

The state’s $1 million investment toward finding a way to prevent ticks from spreading Lyme disease is paying off, a UMass Medical School researcher said Thursday, and an additional investment could move an antibody proven in labs to protect mice against Lyme closer to a human trial.

As Lyme, a tick-borne bacterial infection that can cause neurological problems if left untreated, has spread in both the number of cases and affected geography, Dr. Mark Klempner from the MassBiologics division of UMass Medical School has been leading a team to develop “a novel approach” to preventing the disease.

“It’s really been a spreading, rising tide of cases that are concerning,” he said, noting that the 35,000 to 40,000 reported annual cases of Lyme disease in the United States is “very underreported” and is likely closer to 300,000 annual cases. Since the mid-1990s, he said, the ticks that can carry Lyme disease have increased in concentration and spread from New England and the mid-Atlantic to the upper Midwest.

Klempner’s team secured a $1 million appropriation in the current state budget and, paired with federal grants from the National Institutes of Health, developed a “pre-exposure prophylaxis” in which antibodies injected into a human could block the release of the Lyme bacteria if the human is bitten by an infected tick.

“It’s really based on some very simple notion that the bacteria, before it comes to you, is stuck in the gut of the tick” and must make a complex trip through the tick before it can infect a human, he said Thursday at a briefing. “Our approach is to take advantage of this very complicated pathway for the bacteria to get out of the tick and into you … a medicine that will circulate in you that when the tick drinks it, the blood will contain something that will kill the bacteria in the midgut or for sure prevent it from getting out of the gut so that none of this can happen.”

The team ran an initial test on mice in which the mice were injected with the antibodies and then exposed to six Lyme-infected ticks each. At a dose as low as 5 mg per 2.5 pounds of body weight, the mice were found to be 100% protected from Lyme disease, Klempner said. The team also tested the preventative treatment on a monkey and was able to protect the monkey from Lyme disease exposure.

The development hit a snag, Klempner said, when his team realized that a single injection of antibodies would not protect a human for the duration of tick season.

“Our problem is that we’ve invented a drug that will be there for only a few weeks and yet your time of risk of exposure is many months, typically we say seven to eight months in our area around here,” he said.

Researchers found a way to modify the antibody treatment and extend its usefulness by up to three-and-a-half times in mice, he said, but have not yet been able to test on humans to find out how long the antibodies would sustain in a human body.

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When Lyme Disease Strikes an Unborn Child

•January 27, 2019 • Leave a Comment

Excerpted from Scientific American: (01/25/2019)

A mom can pass the pathogen to her fetus—but the World Health Organization has removed “congenital Lyme disease” from its definitive diagnostic reference


Let’s say, for the sake of argument, you plummet from a ski gondola. Or, equally bad, you contract a fatal illness from eating human brains.

Your risk of experiencing such disasters is low. But these calamities, and many more, are nonetheless covered by the world list of illnesses and injury known as the International Classification of Diseases, or ICD, published by the World Health Organization (WHO). The document tells doctors what to look for, insurers what they might pay for, and health officials—by virtue of numbers—what needs attention.

Last June, seven years into a project involving 30 committees and 11,000 proposals, the WHO released the eleventh version of this tally of human malady. Its 55,000 entries were undergoing final, mostly technical, review when, in December of 2018, something unusual happened: one diagnosis—congenital Lyme disease—slipped from the list. The condition occurs when a pregnant woman infected with the tick-borne disease passes the bacterium, known as a spirochete, to her developing fetus.

Cases of Lyme spirochetes crossing the placenta have been documented since the 1980s, with sometimes terrible consequences for fetuses and newborns. Consider a report in the journal PLOS One, published in November, which examined, among other evidence, the outcomes of 59 women with Lyme disease in pregnancy.

“Newborn died at 39 hours,” reads one entry for a baby with a heart deformity. “Spirochetes … found in spleen, renal tubes and bone marrow.”

“Newborn died at 23 hours due to prenatal brain damage,” reads another. “Spirochetes identified in the brain and liver.”

In all, 10 miscarriages and 10 deaths occurred, along with 16 complications and defects, six of them long-lasting. The overall tally: bad outcomes in 61 percent of cases.

Nine other studies have found indirect evidence of harm: among Lyme-infected mothers who were not treated in pregnancy, 50 percent had adverse outcomes such as congenital abnormalities and miscarriage; just 11 percent of treated women did. This suggests that Lyme disease should be on every obstetrician’s radar.

These and other studies had convinced ICD overseers to include the diagnosis in the first place. But the expansive PLOS One review, published after the new list was unveiled, actually might have convinced WHO otherwise. Fetal outcomes were simply too varied, knowledge gaps large, and study results inconsistent, said the article. For example, six studies showed no significant association between infection and fetal harm. “The global evidence does not fully characterize the potential impact of gestational LD,” the PLOS One article concluded.

In response to questions about the removal of the diagnosis, WHO said in a statement: “(T)here is not sufficient evidence to justify a separate statistical category for congenital Lyme disease.” Instead, when newborns are found to harbor Lyme spirochetes, the statement said, other diagnostic codes can be used. But patient advocates fear this does not give the condition the recognition it deserves.

To its credit, WHO accepted 14 Lyme-related conditions in the new ICD, compared to just four in the previous edition. The new list includes Lyme-related dementia; central nervous system demyelination (similar to multiple sclerosis); ophthalmic complications; neuroborreliosis (which afflicts the nervous system); and carditis, a potentially fatal heart-rhythm dysfunction.

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CDC: Disease-Spreading Asian Tick Found in 9 U.S. States

•December 2, 2018 • Leave a Comment

*The exotic tick can transmit hemorrhagic fever to humans.

Excerpted from US News and World Report: (11/29/2018)


The Centers for Disease Control and Prevention warned Thursday that a dangerous tick capable of spreading diseases in humans and animals has been found in the United States.

The tick is indigenous to eastern China, Japan, eastern Russia and Korea and was introduced in Australia, New Zealand and several island nations in the western Pacific region. Called Haemaphysalis longicornis, or the Asian longhorned tick, the CDC said it can lead to hemorrhagic fever, Lyme disease and a 25 percent reduction of production in dairy cattle.

“The full public health and agricultural impact of this tick discovery and spread is unknown,” said Ben Beard, deputy director of CDC’s Division of Vector-Borne Diseases. “In other parts of the world, the Asian longhorned tick can transmit many types of pathogens common in the United States. We are concerned that this tick, which can cause massive infestations on animals, on people, and in the environment, is spreading in the United States.”

According to the CDC, the tick was first discovered in the U.S. in New Jersey in August 2017 on a sheep and again in the spring of 2018 in the same location. It was later found in other counties in New Jersey and in several other eastern states and Arkansason six species of domestic animals, six species of wildlife and on humans.

Following the discovery, the CDC “expanded surveillance to determine the evolving distribution” of the insect.

The USDA Animal and Plant Inspection Service worked with the CDC to monitor the tick in the United States and search for any additional infestations. The agencies found that from August 2017 to September 2018, 53 reports of the Asian longhorned tick were made in the U.S., with 23 from domestic animals, 15 from grass or vegetation, 13 from wildlife and two from humans.

The USDA Animal and Plant Inspection Service worked with the CDC to monitor the tick in the United States and search for any additional infestations. The agencies found that from August 2017 to September 2018, 53 reports of the Asian longhorned tick were made in the U.S., with 23 from domestic animals, 15 from grass or vegetation, 13 from wildlife and two from humans.

In addition to New Jersey, which had the most incidences, and Arkansas, the tick was found in VirginiaWest VirginiaNew YorkNorth CarolinaPennsylvaniaConnecticut and Maryland. No illnesses were reported in humans or animals.

Examining data from years ago, the CDC retrospectively identified a tick found on a deer in West Virginia in 2010 and one collected from a dog in New Jersey in 2013 as the Asian longhorned tick.

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Lyme Disease Symptoms and Diagnosis

•November 4, 2018 • Leave a Comment

Excerpted from Psychology Today: (11/02/2018)

Lyme disease is the result of infection with one or more species of the spirochete Borrelia Burgdorferi. It is generally thought that the infection is the result of a tick bite, which about 50% of the time results in a rash, often described as a ‘Bulls Eye’ rash, but which can vary in appearance.

Symptoms of untreated Lyme disease typically start with:

  • nondescript flu-like symptoms (fever, chills, body aches, headache)
  • but eventually include joint aches (which may migrate from one joint to another over days),
  • neuropsychiatric problems (e.g., Bell’s palsy-paralysis of one side of the face)
  • fatigue, numbness, weakness
  • mood disorders, OCD, psychosis
  • cognitive impairment, seizures
  • Some people report abnormal heartbeats (conduction abnormalities), or gastrointestinal problems.

There is an extreme polarization of opinion around the twin questions of diagnosis and treatment for those with Lyme disease. The highly charged and politicized conflict between the Infectious Disease Society of America (IDSA) and International Lyme and Associated Diseases Society (ILADS) is well described in Pamela Weintraub’s excellent book, Cure Unknown.

On the one side, is the position of the Infectious Diseases Society of America (IDSA), which has a strict requirement for diagnosis and treatment (, and has concluded that long-term antibiotic therapy (greater than one month) is not indicated in those who continue to have symptoms despite the normal treatment regimen (2-4 weeks of oral or IV antibiotics, depending on the symptoms and laboratory data).

On the other side, is The International Lyme and Associated Diseases Society (ILADS), which is a conglomeration of “Lyme Literate” physicians, non-physician health care practitioners, patients, and their families. They believe that scientific data has proven that residual symptoms are the result of either co-infections or chronic infections.   The tick often contains numerous bacterial and parasitic organisms, such as Bartonella species, Babesia, Ehrlichia, etc. Borrelia Burgdorferi infections may develop, as part of the bacterial life cycle and protective mechanisms, intracellular forms. Because of this, and other defense and host mechanisms, it may not be detectable using routine testing. Furthermore, standard Lyme disease testing (a Western Blot) is believed to highly insensitive, by ILADS, giving rise to many false negatives.

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6 Sneaky Signs of Lyme Disease

•October 28, 2018 • Leave a Comment

Excerpted from The US News & World Report: (06/18/2018)

“Ticks are the epitome of the accidental hitchhiker.”

I recently came across this quote and thought it was a brilliant analogy. You’re enjoying an outdoor hike or family outing, and without your knowledge, you’ve become the host to an unwanted guest. Smaller than the size of an eraser, this pest, better known as a deer tick, not only attaches to your skin and feeds on your blood, but is also the carrier of Lyme disease, a bacterial infection.


Lyme Disease: Symptoms, Prevention and…

Lyme disease is caused by the bite of a deer tick, and most recipients will have no idea they were bitten. And contrary to its name, a deer tick can also be carried by dogs who can infect their canine owners without contracting this bacterial disease themselves.

Typically, the incidence of this disease peaks in the summer months when the deer tick thrives and multiplies. Long known as a disease tiendemic to the northeast, Lyme disease has now been found across America. According to a recent report by the Center for Disease Control and Prevention, “The number of people getting diseases transmitted by mosquito, tick and flea bites has more than tripled in the United States in recent years.”

Though the telltale symptom of the bull’s-eye rash is well known, there are some sneaky and potentially difficult to diagnose symptoms that can mimic other diseases.

Case in point: I recently had a patient who came to the emergency room complaining of shortness of breath and palpitations. Initially, the on-call team thought it was an acute heart problem. But congestive heart failure or a heart attack were eventually ruled out. The patient was found to have a large collection of fluid compressing the heart muscle and was subsequently admitted and diagnosed with pancarditis, or inflammation of the heart muscle and the pericardium, the sac that encases the heart.

We had pinpointed the symptoms but needed a cause. Once CHF and heart attack were ruled out, I had to wonder whether these symptoms were a result of an autoimmune disease, where the body attacks itself. Or could this be a sign of an infection that had been brewing for years?

After running an exhaustive battery of tests, I found the patient had a rip-roaring Lyme infection that had remained indolent for decades.

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New, aggressive tick is now in New Jersey and New York

•August 5, 2018 • Leave a Comment

Longhorned tick clones itself and bleeds livestock dry: It’s already known to spread several human diseases

Excerpted from The Chronicle : (08/04/2018)

The longhorned tick, an invasive species that clones itself and is known to suck livestock dry, is spreading fast. It’s now been confirmed in New Jersey and New York.

The Lyme Disease Association says the longhorned tick is already known to transmit several human diseases, including spotted fever rickettsiosis, in its native East Asian countries of China, Japan, and Australia. It may be only a matter of time before they become carriers of tick-borne diseases that affect humans, it says.

According to the National Veterinary Services Laboratory in Ames, Iowa, this exotic new tick was first found in the United States in Virginia, appearing on an orphaned calf on a beef farm It was also confirmed in West Virginia in May and in Arkansas in June. It’s also in North Carolina.

The tick reached New Jersey in November, when it was found on a sheep farm in Hunterdon County, N.J. Mystery still surrounds its appearance. The species survived the winter. There is no known direct link from the Virginia farm to the New Jersey farm. The longhorned tick has spread to other parts of New Jersey, including Middlesex, Union, Mercer, and Bergen counties.

The longhorned tick reproduces by parthenogenesis, that is, without fertilization. Males are very rare.

The species is dark brown and grows to the size of a pea when fully engorged. Both larval and nymphal stages are very small and difficult to observe with the naked eye. Adult ticks are seen mainly during early summer.

This tick is a serious pest to livestock, says New Jersey Secretary of Agriculture Douglas Fisher. It strikes cattle, horses, farmed deer, sheep, and goats, particularly in New Zealand, as well as wildlife, pets, and humans. The New Jersey Division of Fish and Wildlife is watching to see if the tick has spread to wildlife.

Fisher said farmers should monitor their livestock for the presence of this tick. They should look for decreased growth rates, or signs of anemia.

He said it’s still too early to tell how the new tick will affect local residents.

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