From Eric Gordon, MD
In 2011, Gordon Medical sponsored a conference with Dr. Joseph Burrascanno, MD, which included a panel Q&A with GMA practitioners after the talk. We had so many questions it was impossible to answer them all. That need led to the start of our blog, Unravelling Complex Chronic Illness.
Even though the Q&A was from some years ago, and knowledge about Lyme Disease has changed during that time, you may still find some of these answers from Dr. Gordon helpful.
Below are some answers to questions patients ask about Lyme Disease in pregnancy, and the possibility of transmission from person to person via pregnancy, breastfeeding, intimacy, and other forms of person to person transmission. You might also want to read some of the linked pages for more information.
Always be sure to check with your doctor before making any changes to your treatment.
Links to the Q & A
Pregnancy and Lyme
I passed Lyme to both of my children. If they are on antibiotics during pregnancy, will it prevent passing the Lyme to their children?
If your children have active Lyme, treatment before pregnancy would be the best course. Treatment during pregnancy with antibiotics does prevent transmission of Lyme. Certain antibiotics have been found, in the proper doses, to prevent transmission, and to be safe for the fetus.
There may be a chance of transmission of Lyme bacteria in breast milk, also. If you still have active Lyme disease, you should discuss with your physician whether you should breast feed your child.
UPDATE: Any woman who has Lyme disease and is considering becoming pregnant or who is pregnant, or who is bitten by a tick during pregnancy, should see a Lyme disease doctor, one who understands the serious medical implications of Lyme during pregnancy. The Lyme bacteria, Borrelia burgdorferi, can cross the placenta and can cause death of the fetus. The Lyme Disease Association (LDA) has compiled the following list of articles related to Lyme and pregnancy and Lyme and breastfeeding for informational purposes only, for your review and review by your physician.Updated Pregnancy, Breastfeeding & Lyme Bibliography
Person to Person Transmission Issues
Can Lyme or co-infections be transmitted thru sex or kissing?
Please address whether Lyme is a sexually transmitted disease (STD)?
Can it be transmitted from an adult to young children during normal care giving?
What do you think about the possibility of sexual transmission of Lyme or other Tick-Borne Disease (TBD)?
Can Lyme disease be transmitted through sex or kissing? The answer is through sex, probably; through kissing is much harder. I don’t believe anybody has found Lyme bugs in saliva. Usually you don’t get it from saliva. You might be able get it because there is a cut, there is a little bleeding….
An opening to the bloodstream.
….gums that bleed or something.
Eric, have you heard anything in any of the conferences about what it takes to actually be able to transmit the infection. For example, with sexual transmission, men’s sperm actually suppress women’s immune system so they can impregnate the egg.
So they think that’s why, or it’s part of why, it might be easier to transmit Lyme disease from males to females, but is there anything else that you’ve heard in terms of what it takes to transmit the bacteria, like if it got on your arm could it crawl through the skin….?
No, I wouldn’t believe so. I mean, most bugs don’t do that very effectively.
It takes usually a broken area…. The skin has to be broken. If you had an open cut or an open sore, that would be theoretically possible. But so far, there is no evidence to show that it happens in reality.
These are just guesses. I mean, yes, I’m sure it can happen, but if you look at something like Hepatitis C and AIDS, they are good examples. Hepatitis C is definitely contagious and transmissible through sexual contact, but it still happens to be relatively difficult to do so, and does not happen often.
Yes. Well that’s what I keep trying to say to people when they say, “Well I can get Lyme from mosquitoes,” or “I can get it this way.” Ticks have a very unique transmission process, that suppresses the immune system enough to allow the bacteria a chance to be established.
Yes. Lyme, you probably cannot get from mosquitoes. You can probably get Ehrlichia and any of the Rickettsial things from mosquito bites. And Bartonella may be transmitted through other vectors, but Lyme, I don’t know if it is possible, I don’t think so.
They haven’t been able to prove it yet in transmission studies, so, you know, it seems like when they ask, “Can it be transmitted from an adult to a young child in your daily care taking?” Again, it seems unlikely except….
With Lyme it would be very, very unlikely.
Except, you know that there is a possibility with breastfeeding. Borrelia has been found in breast milk.
Yes, again, could be, but unlikely, because the mother should have some immuneoglobulins going at the same time. So if the breastfeeding is passing the infection, it is also passing protection from the infection. Other than that, you just have to say, what people don’t understand, is that this disease has not been studied.
And people are making these statements based on evidence that could have other interpretations. Like, we know in utero transmission has happened, but we really only have maybe one or two documented cases. Everything else is a guess.
So I have always been uncomfortable about this whole thing. I think you just have to say that it is possible, yes, but likelihood is very low, yes; just like yes, it is possible to win the lottery.
I think the thing that people are asking you, Eric, is do they need to do anything different? Do they need to be concerned in their sexual relationships? Do they need to be concerned when taking care of their children? That’s of course the bottom line about these questions.
The bottom line is that we don’t know, and I think there’s probably a better chance that you can do more harm to your child by worrying about it than by doing it.
Well, there you go.
And as far as relationship, it is the same thing. If you’re in a committed relationship, it’s not something I would worry about. If you are really worried then, get yourself tested! Because you have to remind people that most people who get Lyme can be treated relatively easily. It is only a percentage of people who are more likely to get chronic Lyme disease.
Note: People who are being treated for Lyme disease are less likely to transmit the bacteria, whether it is though the placenta in pregnancy, or through sexual contact. Be aware that other TBDs may be more easily transmitted through human contact. Please discuss any concerns with your doctor.