Routes of transmission

How is Lyme disease transmitted?

  • Via insect/tick vector
  • Blood transfusion
  • Sexual intercourse
  • Vertical/transplacental

In most cases, the tick must be attached for 36 to 48 hours or more and have taken a blood meal before the Lyme disease bacteria can be transmitted. Most humans are infected through the bites of immature ticks called nymphs as they are smaller and remain undetected for longer. Nymphs are less than 2 mm and start to feed during the spring and summer months. Adult ticks can also transmit Lyme disease, but they are much larger are usually detected before transmission of disease can occur.

Although relatively rare, the transmission of Lyme disease can occur via unprotected sexual intercourse and via vertical transmission from mother to child.


References:
Abramowsky C, Beyer-Patterson P, Cortinas E. Nonsyphilitic spirochetosis in second-trimester fetuses. Pediatr Pathol. 1991 Nov-Dec;11(6):827-38.

Aoki SK, Holland PV. Lyme disease–another transfusion risk? Transfusion. 1989 Sep;29(7):646-5.

Bale JF Jr, Murph JR. Congenital infections and the nervous system. Pediatr Clin North Am. 1992 Aug;39(4):669-90.

Böhme M, Schembra J, Bocklage H, Schwenecke S, Fuchs E, Karch H, Wiebecke D.[Infections with Borrelia burgdorferi in Würzburg blood donors: antibody prevalence, clinical aspects and pathogen detection in antibody positive donors]. Beitr Infusionsther. 1992;30:96-9.

Cook MJ. Lyme borreliosis: a review of data on transmission time after tick attachment. Int J Gen Med. 2014 Dec 19;8:1-8.

El-Bahnsawy MM, Labib NA, Abdel-Fattah MA, Ibrahim AM, Morsy TA. Louse and tick borne relapsing fevers. J Egypt Soc Parasitol. 2012 Dec;42(3):625-38.

Figueroa R, Bracero LA, Aguero-Rosenfeld M, Beneck D, Coleman J, Schwartz I. Confirmation of Borrelia burgdorferi spirochetes by polymerase chain reaction in placentas of women with reactive serology for Lyme antibodies.
Gynecol Obstet Invest. 1996;41(4):240-3.

Gabitzsch ES, Piesman J, Dolan MC, Sykes CM, Zeidner NS. Transfer of Borrelia burgdorferi s.s. infection via blood transfusion in a murine model. J Parasitol. 2006 Aug;92(4):869-70.

Kumi-Diaka J, Harris O. Viability of Borrelia burgdorferi in stored semen. Br Vet J. 1995 Mar-Apr;151(2):221-4.

MacDonald AB. Gestational Lyme borreliosis. Implications for the fetus. Rheum Dis Clin North Am. 1989 Nov;15(4):657-77.

MacDonald AB. Human fetal borreliosis, toxemia of pregnancy, and fetal death. Zentralbl Bakteriol Mikrobiol Hyg A. 1986 Dec;263(1-2):189-200.

Silver RM, Yang L, Daynes RA, Branch DW, Salafia CM, Weis JJ. Fetal outcome in murine Lyme disease. Infect Immun. 1995 Jan;63(1):66-72.

Strobino BA1, Williams CL, Abid S, Chalson R, Spierling P. Lyme disease and pregnancy outcome: a prospective study of two thousand prenatal patients. Am J Obstet Gynecol. 1993 Aug;169(2 Pt 1):367-74.

Trevisan G, Stinco G, Cinco M. Neonatal skin lesions due to a spirochetal infection: a case of congenital Lyme borreliosis? Int J Dermatol. 1997 Sep;36(9):677-80.

Williams CL, Strobino B, Weinstein A, Spierling P, Medici F. Maternal Lyme disease and congenital malformations: a cord blood serosurvey in endemic and control areas. Paediatr Perinat Epidemiol. 1995 Jul;9(3):320-30.