Is Lyme Disease Transmitted Sexually Between Humans?

Lyme disease is transmitted by a tick bite, which causes a bull’s eye rash in some people. But what if that person was also infectious to their sexual partners?

The idea is explored by two member of ILADS in a recent editorial.

For those who don’t know the politics of Lyme, The MDs in ILADS fall into the “chronic Lyme is real and it kills” crowd, while the MDs in the CDC crowd tends toward the “it’s all in your head” model. Remember, these are all MDs, many of them with very impressive credentials. They just don’t agree on this issue.

One of the recent wins by ILADS was doing away with the “36 hour attachment rule.” This rule said that if a tick was attached for less than 36 hours, Lyme disease would not be transmitted. Unfortunately, this rule had about as much data behind it as the “five second rule” for dropping food. (Here’s the review of data)

Another victory for ILADs was the extension of the CDC’s recommendations for Lyme prevention once you got bit. A few years ago, MDs were prescribing a single dose of doxycycline. Now they prescribe a month of once a day (or 14 days twice a day).

So should we be worried when ILADS says Lyme can be transmitted sexually? Yes and no. I looked for the semen studies, and didn’t find anything human. There are no documented (in pubmed) cases of human-to-human Lyme sexual transmission. So to say it occurs at a high rate that we can document would be wrong.

But…Lyme transmission can occur through blood transfusions, at least in mice. (Study here) It doesn’t seem to occur from mom to child during pregnancy (old study here). And it wasn’t documented in human blood transfusions twenty years ago (old study here).

It seems like the lines for how and when Lyme was transmitted were drawn twenty years ago, back when the 36 hour rule and one day of antibiotics was considered sufficient. Given the new reality of Lyme, wouldn’t it make sense to revisit the issue with another, follow up study or two? 


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