The purpose of this page is to provide a short overview of scientific research available that discusses transmission of Lyme disease.
Modes other than Ticks
Scientific studies support potential alternate modes of transmission; however these potential transmission sources have not been fully researched. A small selection of available research is offered below.
Blood-sucking insects, such as mosquitoes, flies, fleas and mites
- Dr Steven Luger reported in The New England Journal of Medicine a case in which a patient was bitten by a large fly and presented 13 days later with Lyme symptoms. These were resolved via pharmaceutical treatment.
- A German study of patients with Lyme arthritis identified evidence, through serological test for antibodies to the causative spirochete, that one patient had contracted the disease from a fly.‘Lyme arthritis: Clinical features, serological and radiographic findings of cases in Herzer P, Wilske B, Preac-Mursic V, G Schierz, Schattenkirchner M, & Zollner N. 1986, Lyme Arthritis: Clinical Features, Serological, and Radiographic Findings of Cases in Germany, Klinische Wochenschrift 64:206-215.
- A French study of four Lyme patients ascertained that only one was bitten by a tick; the researchers suggested that two of the patients may have contracted the disease from a mosquito or biting fly.Doby JM, Chastel C, Couatarmanac’h A, Cousanca C, Chevrant-Breton J, Martin A, Legay B & Guiquen C. 1985, Etiologic and epidemiologic questions posed by erythema chronicum migrans and Lyme disease, Bull Soc Pathol Exot Filiales 78(4):512-525.
- Borrelia burgdorferi was identified in 13 species of mites, 15 species of flies and two species fleas.Pokornỳ P. 1989, Incidence of the spirochete Borrelia burgdorferi in arthopods (Arthropoda) and antibodies in vertebrates (Vertebrata), Cesk Epidemiol Mikrobiol Imunol. 38(1):52-60.
- A study identified Borrelia spirochetes in mosquitoes and fleas.Hubálek Z, Halouzka J & Juřicová Z. 1998, Investigation of haematophagous arthropods for borreliae – summarised data 1988-1996, Folia Parasitologica 45: 67-72.
- Borrelia burgdorferi spirochetes identifiedin mosquitoes and flies.Magnarelli LA & Anderson JF. 1988, Tick and biting insects infected with the etiologic agent of Lyme disease, Borrelia burgdorferi, J. Clin. Microbiol. 26(8):1482.
- Borrelia afzelii spirochetes identified in female mosquitoes of the genus Culex, Aedes and Anopheles.Zákovská A, Capková L, Serỳ O, Halouzka J & Dendis M. 2006,Isolation of Borrelia afzelii from Overwintering Culex Pipiens Biotype Molestus Mosquitoes, Ann Agric Environ Med. 13(2):345-348.
Transplacental transmission
- The issue of transplacental (mother to child in utero) transmission is raised in the LDAA’s formal response to DoH Scoping Study on Lyme disease (page 16) from Gardner T. 2001, ‘Lyme disease’ in J Remington & JO Klein (eds), Infectious Diseases of the Fetus and Newborn Infant, 5th edn. Philidelphia, WB Saunders; 519-641
- A compilation of peer-reviewed journal articles indicating that Lyme could be contracted in utero is available on the LDAA website.
Contact with urine and other bodily fluids from infected animals
The potential for humans to contract Lyme disease via an infected mammal is an area that has yet to be fully researched, however remains of concern to the LDAA and Lyme patients.
- There is ample evidence of Borrelia in mammals reported in Australian and overseas research:
- An Australian study found Borrelia spirochetes in cattle, rodents, kangaroos and bandicoots. Mackerras MJ. 1959, The haematozoa of Australian mammals. Aust J Zool. vol. 7: 105-135.
- An Australian study identified a new species of Borrelia (B. queenslandica), in the blood of rats. Carley JG & Pope JH. 1962, A new species of Borrelia (B. queenslandica) from Rattus Villosissimus in Queensland, Aust J Exp Biol. Vol. 40:255-262.
- Borrelia antibodies were identified in 22 mammalian species, including carnivores and rodents. Pokornỳ P. 1989, Incidence of the spirochete Borrelia burgdorferi in arthopods (Arthropoda) and antibodies in vertebrates (Vertebrata), Cesk Epidemiol Mikrobiol Imunol. 38(1):52-60.
- Evidence of Borrelia found in systemically ill cats and dogs in the UK. Shaw SE, BInns SH, Birtles RJ, Day MJ, Smithson R & Kenny MJ. 2005, Molecular evidence of tick-transmitted infections in dogs and cats in the United Kingdom, Vet Rec Nov 19; 157(21): 645-648.
- Positive ELISA results for Borrelia antibodies in horses. Sorensen K, Neely DP, Grappell PM & Reed W. 1990, Lyme disease antibodies in thoroughbred broodmares, correlation to early pregnancy failure, Equine Vet J, 10(3): 166-168.
- Transmission of Borrelia from animals to humans could theoretically occur via exposure to their urine, blood, semen, colostrums or synovial fluid, as detailed below.
- The LDAA Australian patient report (2012), page 12, Table 2 and page 14, Table 4 included respondents nominating other suspected modes of transmission via animals including, urine, saliva and milk.
- Live Borrelia burgdorferi was isolated in the blood and urine of white-footed mice. The authors reported that “Spirochetes remained viable for 18-24 hours in urine.” Bosler EM & Schulze TL. 1986, The prevalence and significance of Borrelia burgdorferi in the urine of feral reservoir hosts, Zentralbl Bakteriol Mikroboil Hyg A., Dec; 263(1-2): 40-44.
- Borrelia burgdorferi was isolated in the blood of a dog three and four weeks post infection. Cerri D, Farina R, Andreani E, Nuvoloni R, Pedrini A & Cardini G. 1994, Experimental infection of dogs with Borrelia burgdorferi, Res Vet Sci, 57(2): 256-258.
- Horse and cow blood, cow colostrums, cow urine and cow synovial fluids found to be Borrelia burgdorferi culture positive. Burgess EC. 1998, Borrelia burgdorferi infection in Wisconsin horses and cows, Ann N Y Acad Sci, 539:235-243.
- The West Australian Lyme Association’s submission in response to the DoH Scoping Study on Lyme Disease explores the potential role of livestock and their reproductive products in transporting (and possibly transmitting) Lyme disease, including:
- Limited screening of imported livestock through quarantine process (Pages 5-6).
- Screening process in interstate transport of livestock is not always adequate (Page 6).
- Potential for Borrelia to survive in imported frozen semen and ova (P 9-10). Borrelia burgdorferi spirochetes were found to have a mean viability of 90%+ after being frozen at minus-196 Celsius for 12 weeks. ‘Viability of Borrelia burgdorferi in Stored Semen’, Kumi-Diaka, J. and Harris, O, (1995) British Veterinary Journal, Mar/Apr 1995. v. 151 (2)
- Lack of facilities in Australia to test livestock suspected of infection with Lyme disease (Page 11).
- The submission can be found here.
- An extensive collection of research regarding the role of mammals and birds in the transmission cycle of Lyme disease has been compiled on the website of Australian researcher (and Lyme patient), Karen Smith.
Transmission via blood, tissue and organ donations
- The LDAA has repeatedly raised concerns about the lack of screening of Australian blood supplies for Borrelia and known co-infections.
- At this time, public safety relies on voluntary ‘opting out‘ of blood and organ donation programs by those who are aware they are infected with Lyme disease and co-infections. This is of major concern, given the number of people in the Australian population likely to be undiagnosed with these infections.
- The LDAA again raised the concerns in the formal response to the DoH Scoping Study (pages 39-40) in relation to public risk through blood transfusions.
- The LDAA’s Patient-Focused Action Plan, appended to the Scoping Study Response, called for:
- Screening of blood for Borrelia, Babesia, and other known co-infections.
- Notification to organ donors to withdraw from program after suspected tick bites.
- Research supporting concerns about potential transmission through blood include:
- US studies have found Borrelia “may survive storage under blood banking conditions and that transfusion-related Lyme disease is theoretically possible”
Nadelman RB, Sherer C, Mack L, Pavia CS & Wormser GP. 1990, Survival of Borrelia burgdorferi in human blood stored under blood banking conditions , Transfusion, 30(4):298-301. - Transfusion recipients (136) contracted Babesiosis (potentially fatal, Lyme disease co-infection) via the donated blood supply. Herwaldt BL, Linden JV, Bossernman E, Young C, Olkowska D & Wilson M. 2011, Transfusion-associated Babesiosis in the United States: a description of cases, Annals of internal medicine, 155(8):509-519.
- An article raising concerns about the transfusion-based transfusion was published. Leiby DA. 2011, Transfusion-associated babesiosis: shouldn’t we be ticked off? Annals of internal medicine 155(8), 556-557.
- US studies have found Borrelia “may survive storage under blood banking conditions and that transfusion-related Lyme disease is theoretically possible”
Sexual transmission
- There is a growing body of anecdotal evidence among the Australian Lyme community indicating that Lyme disease may be sexually transmitted. This anecdotal evidence is supported, at this stage, by limited scientific research; however Lyme patients are urged to practice safe sex as a precaution.
- A 2001 study found that sexual partners of Lyme patients were likely to carry Borrelia themselves. Bach G. 2001 April, ‘Recovery of Lyme spirochetes by PCR in semen samples of previously diagnosed Lyme disease patients’, International Scientific Conference on Lyme disease.
- Newly published research provides evidence that Borrelia burgdorferi may be transmissible through both vaginal secretions and seminal fluid, again suggesting sexual transmission.
Middelveen, MJ, Bandoski, C, Burke J, Sapi E, Mayne PJ, Stricker RB, 2104, ‘Isolation and Detection of Borrelia burgdorferi from Human Vaginal and Seminal Secretions’, Presented at the Western Regional Meeting of the American Federation for Medical Research, Carmel, CA, January 25, 2014. - In an interview regarding this research, Australia’s Dr Peter Mayne said, “…the presence of the Lyme spirochete in genital secretions and identical strains in married couples strongly suggests that sexual transmission of the disease occurs.”
- The LDAA contends further research is required to confirm the growing body of anecdotal evidence and preliminary research which suggests these alternate modes of transmission are possible. LDAA, Patient submission to the Australian Government Department of Health’s ‘Scoping Study to develop a research project(s) to investigate the presence or absence of Lyme disease in Australia’ (pages 11, 43, 44 and 47).