CDC FAQ: Can Lyme disease be transmitted sexually?

Topics with information and discussion about published studies related to Lyme disease and other tick-borne diseases.
Martian
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CDC FAQ: Can Lyme disease be transmitted sexually?

Post by Martian » Sun 2 Feb 2014 1:31

Because of the current active topic about sexual transmission of Bb, here a repost of something Bagge posted on this board in May 2012.


Source: http://www.cdc.gov/lyme/faq/index.html#sexually
Can Lyme disease be transmitted sexually?

There is no credible scientific evidence that Lyme disease can be spread from person-to-person through sexual contact. The biology of the Lyme spirochete is not consistent with sexual transmission, attempts to demonstrate sexual transmission in infected animals have all failed, and there has not been a single, adequately documented case of sexual transmission of Lyme disease reported in the scientific literature.

The following are some of the false arguments put forth to suggest sexual transmission:
  • Borrelia burgdorferi and Treponema pallidum (the cause of syphilis) are both spirochetes (cork screw shaped bacteria). Therefore, B. burgdorferi can be transmitted like syphilis.

    Not true. Although B. burgdorferi and T. pallidum are both spirochetes, they are not closely related. More importantly, they behave very differently within humans in ways that affect their potential for sexual transmission. T. pallidum spirochetes produce moist, superficial skin lesions (e.g., chancres on the genital, anal or oral mucosa) that contain enormous numbers of living spirochetes and are crucial to transmission by sexual contact. In contrast, B. burgdorferi spirochetes cannot survive on the surface of the skin or genital mucosa. They are present only in sparse numbers and only in the deep inner layers of the skin. Whereas syphilis spirochetes can penetrate the skin directly, Lyme disease spirochetes require a highly ordered metabolic process associated with feeding by certain species of ticks.
  • Borrelia burgdorferi has been isolated from breast milk and semen.

    Actually, it hasn' t. A single study reportedly found evidence of Borrelia DNA in breast milk using a polymerase chain reaction (PCR) assay. PCR assays detect DNA from dead or living organisms, do not demonstrate the presence of living organisms, and are prone to false positive results. Peer-reviewed and published studies of semen have involved collecting semen from animals, inoculating the semen with bacterial growth media and millions of B. burgdorferi, and then artificially inseminating the animal with the media containing experimentally B. burgdorferi infected semen. The results of these studies provide no evidence that B. burgdorferi occurs naturally in semen.
  • Husband and wife both have Lyme disease, and at least one doesn' t remember a tick bite.

    It is not uncommon for more than one person in a household to develop Lyme disease. This occurs because household members share the same environment where infected ticks are abundant. Patients are often unaware of having been bitten because the ticks that transmit Lyme disease are extremely small.
References:

Woodrum JE, Oliver JH, Jr., 1999. Investigation of venereal, transplacental, and contact transmission of the Lyme disease spirochete, Borrelia burgdorferi, in Syrian hamsters. J Parasitol 85: 426-30.

Moody KD, Barthold SW, 1991. Relative infectivity of Borrelia burgdorferi in Lewis rats by various routes of inoculation. Am J Trop Med Hyg 44: 135-9.

Schmid GP, 1989. Epidemiology and clinical similarities of human spirochetal diseases. Rev Infect Dis 11 Suppl 6: S1460-9.

Porcella SF, Schwan TG, 2001. Borrelia burgdorferi and Treponema pallidum: a comparison of functional genomics, environmental adaptations, and pathogenic mechanisms. J Clin Invest 107: 651-6.

Schmidt BL, Aberer E, Stockenhuber C, Klade H, Breier F, Luger A, 1995. Detection of Borrelia burgdorferi DNA by polymerase chain reaction in the urine and breast milk of patients with Lyme borreliosis. Diagn Microbiol Infect Dis 21: 121-8.

Kumi-Diaka J, Harris O, 1995. Viability of Borrelia burgdorferi in stored semen. Br Vet J 151: 221-4.

volumi
Posts: 28
Joined: Thu 30 Jan 2014 17:18

Re: CDC FAQ: Can Lyme disease be transmitted sexually?

Post by volumi » Sun 2 Feb 2014 2:15

What about the cases in so-called non-endemic areas with where one partner is sick, and the other gets ill later on? Possibility? So, what would it mean exactly if it were proven to be sexually transmitted?

Just a thought.

Martian
Posts: 1944
Joined: Thu 26 Jul 2007 18:29
Location: Friesland, the Netherlands

Re: CDC FAQ: Can Lyme disease be transmitted sexually?

Post by Martian » Sun 2 Feb 2014 2:18

I will now post abstracts of the references used in the CDC text, in chronological order.


Source: http://www.ncbi.nlm.nih.gov/pubmed/2682958
Rev Infect Dis. 1989 Sep-Oct;11 Suppl 6:S1460-9.

Epidemiology and clinical similarities of human spirochetal diseases.

Schmid GP.

Division of Sexually Transmitted Diseases, Centers for Disease Control, Atlanta, Georgia 30333.

Abstract

Lyme disease, first identified in 1975, is the most recently recognized of the seven human spirochetal diseases; the evolving clinical picture of Lyme disease indicates it shares many features with the other diseases. These similarities are striking in view of the diverse epidemiology of the seven diseases, which are caused by Treponema species (spread by human-to-human contact) or Leptospira or Borrelia species (zoonoses). These similarities include the following: (1) skin or mucous membrane as portal of entry; (2) spirochetemia early in the course of disease, with wide dissemination through tissue and body fluid; and (3) one or more subsequent stages of disease, often with intervening latent periods. Lyme disease shares with many spirochetal diseases a tropism for skin and neurologic and cardiovascular manifestations, whereas chronic arthritis is unique to Lyme disease. These similarities and dissimilarities offer opportunities to discover which properties unique to the pathogenic spirochetes are responsible for clinical manifestations and suggest that certain clinical features of patients with spirochetal diseases other than Lyme disease may someday be recognized in patients with Lyme disease.

PMID: 2682958 [PubMed - indexed for MEDLINE]
Preview of the full text: http://www.jstor.org/stable/4455356

Martian
Posts: 1944
Joined: Thu 26 Jul 2007 18:29
Location: Friesland, the Netherlands

Re: CDC FAQ: Can Lyme disease be transmitted sexually?

Post by Martian » Sun 2 Feb 2014 2:37

Source: http://www.ncbi.nlm.nih.gov/pubmed/2012256
Am J Trop Med Hyg. 1991 Feb;44(2):135-9.

Relative infectivity of Borrelia burgdorferi in Lewis rats by various routes of inoculation.

Moody KD, Barthold SW.

Section of Comparative Medicine, Yale University School of Medicine, New Haven, Connecticut.

Abstract

Various routes of Borrelia burgdorferi infection were studied in laboratory rats. Three-week-old Lewis rats were inoculated either intradermally (i.d.), intraperitoneally (i.p.), or oronasally (o.n.) with serial 10-fold dilutions of B. burgdorferi. Thirty days later, groups of rats were killed and serology, splenic culture, and histology were used to evaluate infection. Rats were successfully infected i.d. with 10(2-4) organisms or i.p. with 10(4-5) organisms. Neither three-day-old nor three-week-old rats were successfully infected o.n. with up to 10(6) organisms. For contact transmission, three-day-old or three-week-old inoculated rats were housed with unexposed littermates for 30 days. Inoculated rats became infected but contact rats remained free of infection. To study in utero transmission, five pregnant female Lewis rats were inoculated i.p. with 10(6) spirochetes at four days gestation. Although adult females seroconverted or had positive splenic cultures at 20 days gestation, the placentas and fetuses were uniformly culture-negative. Venereal transmission from seven infected females or six infected males to uninfected rats of the opposite sex was not demonstrated.

PMID: 2012256 [PubMed - indexed for MEDLINE]

Martian
Posts: 1944
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Re: CDC FAQ: Can Lyme disease be transmitted sexually?

Post by Martian » Sun 2 Feb 2014 2:47

Source: http://www.ncbi.nlm.nih.gov/pubmed/7648832
Diagn Microbiol Infect Dis. 1995 Mar;21(3):121-8.

Detection of Borrelia burgdorferi DNA by polymerase chain reaction in the urine and breast milk of patients with Lyme borreliosis.

Schmidt BL, Aberer E, Stockenhuber C, Klade H, Breier F, Luger A.

Ludwig Boltzmann Institute for Dermato-Venerological Serodiagnosis, University of Vienna, Austria.

Abstract

Current laboratory diagnosis of Lyme borreliosis relies on tests for the detection of antibodies to Borrelia burgdorferi with known limitations. By using a simple extraction procedure for urine samples, B. burgdorferi DNA was amplified by a nested PCR with primers that target the specific part of the flagellin gene. To control possible inhibition of the enzyme (polymerase), a special assay using the same primers was developed. We examined 403 urine samples from 185 patients with skin manifestations of Lyme borreliosis. Before treatment, B. burgdorferi DNA was detected in 88 of 97 patients with Lyme borreliosis. After treatment, all but seven patients became nonreactive. Six of these seven persons suffered from intermittent migratory arthralgias or myalgias, and one from acrodermatitis chronica atrophicans. Two of 49 control patients with various dermatologic disorders and none out of 22 presumably healthy persons were reactive in the PCR. In addition to urine, breast milk from two lactating women with erythema migrans was tested and also found reactive. Borrelia burgdorferi DNA can be detected with high sensitivity (91%) by a nested PCR in urine of patients with Lyme borreliosis. In addition, this test can be a reliable marker for the efficacy of treatment.

PMID: 7648832 [PubMed - indexed for MEDLINE]

Martian
Posts: 1944
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Re: CDC FAQ: Can Lyme disease be transmitted sexually?

Post by Martian » Sun 2 Feb 2014 2:52

Source: http://www.ncbi.nlm.nih.gov/pubmed/8920118
Br Vet J. 1995 Mar-Apr;151(2):221-4.

Viability of Borrelia burgdorferi in stored semen.

Kumi-Diaka J, Harris O.

Department of Medical Sciences, University of Wisconsin-Madison 53706, USA.

PMID: 8920118 [PubMed - indexed for MEDLINE]
Apparently no abstract is available.

Martian
Posts: 1944
Joined: Thu 26 Jul 2007 18:29
Location: Friesland, the Netherlands

Re: CDC FAQ: Can Lyme disease be transmitted sexually?

Post by Martian » Sun 2 Feb 2014 2:58

Source: http://www.ncbi.nlm.nih.gov/pubmed/10386432
J Parasitol. 1999 Jun;85(3):426-30.

Investigation of venereal, transplacental, and contact transmission of the Lyme disease spirochete, Borrelia burgdorferi, in Syrian hamsters.

Woodrum JE, Oliver JH Jr.

Institute of Arthropodology and Parasitology, Department of Biology, Georgia Southern University, Statesboro 30460, USA.

Abstract

A hamster was inoculated with the SI-1 strain of Borrelia burgdorferi and subsequently served as a host to larval Ixodes scapularis Say. Approximately 68% of the nymphs resulting from the fed larvae were infected. Nymphs from this group were fed on uninfected hamsters, and 3 of 4 males and 6 of 6 females became infected. The infected hamsters were allowed to mate with uninfected partners to test for venereal transmission. Six infected females were mated with 6 uninfected males, whereas 3 infected males were mated with 6 uninfected females. None of the uninfected hamsters became infected after mating. Two protocols were used to determine if transplacental transmission of B. burgdorferi occurred. One group included 6 nonpregnant infected females that were subsequently mated and became pregnant. Three of the females were allowed to carry to full term, whereas the other 3 were killed prior to parturition. All fetuses and offspring were negative for B. burgdorferi based on cultures and monoclonal antibody assays. Another group of 6 females was infected via tick bite after becoming pregnant; those females were allowed to carry fetuses to birth and all were negative. Attempts at contact transmission of B. burgdorferi from 2 infected females to 2 uninfected male and 2 uninfected female hamsters and from 2 infected males to 2 uninfected male and uninfected female hamsters via urine or feces failed.

PMID: 10386432 [PubMed - indexed for MEDLINE]

Martian
Posts: 1944
Joined: Thu 26 Jul 2007 18:29
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Re: CDC FAQ: Can Lyme disease be transmitted sexually?

Post by Martian » Sun 2 Feb 2014 3:02

Source: http://www.ncbi.nlm.nih.gov/pubmed/11254661
J Clin Invest. 2001 Mar;107(6):651-6.

Borrelia burgdorferi and Treponema pallidum: a comparison of functional genomics, environmental adaptations, and pathogenic mechanisms.

Porcella SF, Schwan TG.

Laboratory of Human Bacterial Pathogenesis, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases/NIH, 903 South 4th Street, Hamilton, MT 59840, USA.

PMID: 11254661 [PubMed - indexed for MEDLINE]
PMCID: PMC208952
Free full text: http://dx.doi.org/10.1172/JCI12484

Martian
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Re: CDC FAQ: Can Lyme disease be transmitted sexually?

Post by Martian » Sun 2 Feb 2014 3:04

volumi wrote:What about the cases in so-called non-endemic areas with where one partner is sick, and the other gets ill later on? Possibility?
Can you provide references to studies?

volumi
Posts: 28
Joined: Thu 30 Jan 2014 17:18

Re: CDC FAQ: Can Lyme disease be transmitted sexually?

Post by volumi » Sun 2 Feb 2014 3:14

No.

It was a thought only, like I blankly stated. I was seeking your input here.

Thanks anyway, tho.

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