Why No Ticks?
There is no good reason to think Lyme borreliosis is transmitted only by Ixodes ticks.
Most people visiting our website are probably surprised we don’t talk a lot about ticks. Most Lyme disease information sources limit their discussion to infection from a tick bite. But until more is known about other types of transmission, it is irresponsible to say, or even imply, that Borrelia burgdorferi can be transmitted only by tick bite.
The Blood Transfusion Question
Even some of the most staunch Lyme disease ideologues like Gary Wormser know this: 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. PMID: 2349627 (Note that the big shift in turning Lyme borreliosis into a hard-to-catch, easy-to-cure dogma did not swing into full force until the early 1990s. Fortunately, the National Library of Medicine keeps records of pre-dogma papers.)
Jumping into the historical timeline, we see Eugene Shapiro, the same guy seen in the film Under Our Skin harassing treating physicians and making outrageous statements, already cranking up the denialism campaign in 1994:
The risk of acquiring Lyme disease or babesiosis from a blood transfusion. Gerber MA, Shapiro ED, Krause PJ, Cable RG, Badon SJ, Ryan RW.J Infect Dis. 1994 Jul;170(1):231-4. PMID: 8014507
We have not analyzed this paper, but from the abstract it seems the authors are basing their conclusions on testing for antibodies to Bb six weeks after a transfusion and using clinical assessments by doctors with a bias toward diagnosing as few cases of Lyme disease as possible. Six weeks is pretty early to expect seroconversion from Bb infection and certainly only a weak indication patients were Bb-free. Antibody testing has been repeatedly shown to miss cases of culture- and DNA-positive infection. Shapiro’s entire case is weak, certainly less evidence than what a responsible doctor would like to see for assurance that Bb is not transmitted by blood trasnfusion. And, by the way, his study showed Babesia, a borreliosis coinfection that can cause serious disease, can be transmitted by infusion.
(This is the same Eugene Shapiro quoted in a medical journal that he cannot provide data from one of his studies because he keeps his data “in storage”.)
There is a startlingly small number of published scientific studies that look at blood transfusion transmission of Bb. Readers can look at the literature and decide whether the question has been answered with enough certainty. Keep in mind it is extremely hard to culture Bb or find DNA-RNA evidence, our most definitive indicators of Bb infection, so not finding that type of evidence is typical.
The NIH should be investing taxpayer money to assure the blood supply is safe from Bb instead of funding commercial interests trying to make a Lyme disease vaccine. A Lyme borreliosis vaccine is highly unlikely to ever be successful because of the complexities of borreliosis and the increasing evidence indicating that Bb immunity will not come from a vaccine. Efforts to produce Lyme disease vaccines in the 1990s were abysmal failures.
The Bigger Picture
Before looking at other probable ways that Bb is transmitted, it might help to look at Dr. William Harvey’s paper that asks the right questions and deals directly with the reality of illness from borreliosis. Often, it is best to start by acknowledging broader realities, as Dr. Harvey does.
In summary, Dr. Harvey relates how multiple members of families were being diagnosed with multiple sclerosis in his area. Multiple sclerosis is a condition that is difficult to tell from Lyme disease and has no reliable test for diagnosis. Often, what one doctor calls multiple sclerosis can just as easily be diagnosed as Lyme disease and the patient responds dramatically to antibiotics. This begs an obvious question…
Are there any indications that Bb can be transmitted by close, non-sexual contact?
In 1986, the 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.
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.
Syphilis, another spirochetal disease closely related to Lyme borreliosis, is. of course, sexually transmitted. Bb has been found in human semen. 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. These results were not published in a medical journal, probably because of censorship, pervasively common at that time, or perhaps because of lack of funding for treating physicians doing research.
On April 27, 2009, the National Library of Medicine listed 8576 medical journal papers related to Lyme disease. They listed one paper regarding sexual transmission of Lyme disease, and that was a chance mismatch of a word combination. Searching “sexual transmission Borrelia” produced three results: two of them duplicates and all concerning ticks having sex with ticks.
For quite some time, we wanted to get most, if not all, of our information on borreliosis from medical journals. Gradually, we found that the journals routinely censor valid work, often publish sloppy and illogical papers, and their peer review consists mostly of an if-you-approve-my-paper-I-will-approve-yours system. This was a disappointment, because we really believe good science can help society answer questions.
Back to the Ticks
Most of the foregoing are details of a big subject. This article is not trying to make the best scientific case for non-tick transmission of Bb; that would be the subject of a book, maybe several books. We are only trying to explain why we do not spend much time or effort talking about ticks here. Bottom-line, tick transmission of borreliosis has been covered pretty well elsewhere while we see almost no research evaluating the risks of non-tick transmission.
The Precautionary Principle and Borreliosis
Many people concerned about the environment advocate use of the precautionary principle: if an action or policy might cause severe or irreversible harm to the public or to the environment, in the absence of a scientific consensus that harm would not ensue, the burden of proof falls on those who would advocate taking the action or endorsing the policy. Since the policy of endorsing denial of non-tick transmission of Bb definitely has potential to cause severe or irreversible harm to the public, the precautionary principle applies.
Of course, be ever-vigilant about tick bites. You can certainly contract severely disabling, possibly fatal, diseases from a tick bite. What precisely you should do after a tick bite is still an open question. Most of the research on this subject has been done by some of the least reliable Lyme disease researchers. But, no one, especially not public health officials, should assume you can get Lyme disease only from a tick.