These modes of transmission only serve to increase the methods which Borrelia burgdorferi infections can be contracted

From: JWissmille (jwissmille_at_aol.com)
Date: 09/02/04 

Date: 02 Sep 2004 01:33:29 GMT

Transmission by Contact via Feces, urine or Tick-excretes
- can Borrelia burgdorferi enter through intact mucous membranes?:

96414111 Eur J Epidemiol 1996 Feb; 12(1): 9-11 [Scanned and open in Imaging,
part of Windows95/98]
Unusual features in the epidemiology of Lyme borreliosis.
Angelov L
In this study two cases of Lyme borreliosis are presented. First, the author
describes how he contracted Lyme borreliosis 24 hours after he visited an
endemic area. The second case described is that of a woman who developed Lyme
borreliosis symptoms, when intestinal content of an infected tick came into
contact with her conjunctiva. In both cases the diagnosis is based on clinical
picture and positive serological tests. The first case shows the probability of
contracting Lyme borreliosis when the duration of the tick's attachment to the
skin is less than 24 hours. The second case, described demonstrates
transmission of B. burgdorferi by contact.
Apart from the two cases mentioned in the abstract the author tells about two
other cases of direct transmission, he'd heard of:
1. 1989 Prag conference - a laboratory worker, during handling of a tick, the
tick dropped onto a hot lamp. The tick bursted and the intestinal material hit
the eye of the lab worker, who developed conjunctivitis and positive borrelia
serology.
If anyone know the identity and country of this lab. worker - then please send
a note to me at kroun@ulmar.dk
2. A case from Sweden: EM developed in a scratch-wound that was contaminated
with maneuver in which B. burgdorferi was found.

87208557 Zentralbl Bakteriol Mikrobiol Hyg A 1986 Dec; 263(1-2): 49-54 [have,
not scanned]
Experimental inoculation of dogs with Borrelia burgdorferi.
Burgess EC
To determine if dogs could serve as a reservoir for Borrelia burgdorferi, three
beagles were inoculated subcutaneously (SQ) with 200 laboratory cultured
spirochetes which were originally isolated from blood of a Peromyscus leucopus
from Ft. McCoy, Wisc. One four month old beagle was inoculated SQ with 5 ground
Ixodes dammini from Shelter Island, N.Y. which came from an area with a 50% B.
burgdorferi tick infection rate; and another uninfected four month old beagle
was housed loose on the floor with the tick inoculated dog. All three
spirochete inoculated beagles developed IFA antibody titers to B. burgdorferi
of (7 log2) to (8 log2) by day 28 post inoculation. All were apparently healthy
and no spirochetes were cultured from the blood. In an attempt to exacerbate
the disease two of the dogs were given 3 mg of dexamethasone on day 68 post
inoculation. B. burgdorferi was isolated from blood of all these dogs on days 4
and 97 days post inoculation. The tick inoculated dog developed a B.
burgdorferi IFA antibody titer of (10 log2) by day 14 post inoculation. The
contact exposed dog also developed a B. burgdorferi IFA antibody titer of (7
log2) on post contact day 21 indicating contact infection. B. burgdorferi was
not isolated from either of these dogs. These results indicate that, contact
transmission of B. burgdorferi may occur between dogs, dogs can be
subclinically infected with B. burgdorferi and have persistent infections.

88292734 Am J Vet Res 1988 Jun; 49(6): 752-7
Clinical and serologic evaluations of induced Borrelia burgdorferi infection in
dogs.
Greene RT, Levine JF, Breitschwerdt EB, Walker RL, Berkhoff HA, Cullen J,
Nicholson WL
Adult Beagles were used to evaluate clinical signs and serologic response after
inoculation with, or exposure to, Borrelia burgdorferi. An indirect
immunofluorescent assay (IFA) and 2 ELISA were used to monitor the serologic
response to B burgdorferi. Feeding infected ticks on 4 dogs (group 1) failed to
cause seroconversion, and SC inoculation with 500 organisms caused minimal
seroconversion in 2 of 4 dogs (group 2). At 56 days, approximately 3.01 X 10(8)
B burgdorferi organisms were injected IV into group-1 dogs, and
intraperitoneally into group-2 dogs. A control group of 4 dogs (group 3) had
noninfected ticks feed on them, and then were given IV injection of physiologic
saline solution. Increases in immunoglobulin M (IgM) titers were detected in 2
of 4 group-2 dogs approximately 7 days after the initial exposure. These titers
returned to negligible values 20 days later. Immunoglobulin G titers increased
approximately 10 days after the initial exposure and were mildly increased 56
days later, when dogs were exposed a second time. Both the IV and
intraperitoneal injections (second exposures) resulted in increased IgM titers,
which in both groups eventually returned to preexposure values after
approximately 2 months. Immunoglobulin G titers increased within a week after
the second exposure, and in 3 dogs monitored for 8 months, returned to
negligible values after the 8-month period. One control dog had a slightly
increased IgG titer 24 days after the second inoculation. The possibility of
urine transmission is suggested. Clinical status, hemograms, serum biochemical
profiles, ECG and results of urinalyses remained normal throughout the
study.(ABSTRACT TRUNCATED AT 250 WORDS)

87208555 Zentralbl Bakteriol Mikrobiol Hyg A 1986 Dec; 263(1-2): 40-4
The prevalence and significance of Borrelia burgdorferi in the urine of feral
reservoir hosts.
Bosler EM, Schulze TL
Live Borrelia burgdorferi were isolated from the blood and/or urine of
white-footed mice (Peromyscus leucopus) collected on Shelter Island, New York,
in 1984 and 1985. Prevalence of spirochetes in urine was consistently higher
than in blood or both fluids simultaneously. Spirochetes remained viable for
18-24 hours in urine and were maintained in culture for one week. Mice removed
from the field were spirocheturic for at least 13 months. One spirocheturic
mouse developed spirochetemia one month after field removal indicating the
pathogen can return to the peripheral circulation. Twenty-one kidneys from 22
mice had spirochetes in the interstitial areas and bridging the tubules. A
positive correlation between Babesia microti infection and spirocheturia was
seen. Although the mechanism of entry into the urine is unknown, B. microti
infection may increase glomerular permeability. Babesia induced hematuria may
provide possible nutrients to maintain spirochetes. Urine may provide a method
for contact non-tick transmission of B. burgdorferi in natural rodent
populations particularly during periods of nesting and/or breeding.

Transmission by MILK or food?

Most spirochetes (and other bacteria) ingested will probably be killed by the
high acidic content in the stomach, but people with achlorhydria and newborns
that have very low stomach acid production, does not have this protective
barrier and might be at increased risk for getting infected by the oral route,
if they ingest live spirochetes.
Pasteurizing the milk and never eat semi-raw meat - must be recommended as
prophylaxis.

89048796 Ann N Y Acad Sci 1988; 539: 235-43 Borrelia burgdorferi infection in
Wisconsin horses and cows.
Burgess EC
Blood samples from Wisconsin horses and cows suspected of having clinical
disease due to Borrelia burgdorferi infection were submitted by veterinary
practitioners. All serum, milk, colostrum, and synovial samples were tested for
B. burgdorferi antibodies by immunofluorescence. Whole blood, milk, colostrum,
and synovial fluid samples were cultured for B. burgdorferi. Records were kept
on the clinical signs of antibody-positive animals, date of sample, and
location of the animal by county. Of the samples tested for antibodies 282/430
cow sera, 118/190 horse sera, 5/10 cow synovial fluids, 3/6 horse synovial
fluids, 2/3 cow colostrums, 0/44 cow milk samples and 1 aborted fetus serum
were antibody positive at a titer of 1:128 or greater. Of samples cultured
7/156 cow bloods, 2/35 horse bloods, 1/14 cow synovial fluids, 0/4 synovial
fluids, 1/3 cow colostrums, 0/44 cow milk, and 2/10 cow urine samples were B.
burgdorferi culture positive. For both cows and horses October and May were the
two peak months for the number of antibody-positive samples. The most frequent
clinical signs in antibody-positive horses and cows were lameness and swollen
joints, but many also had stiffness, laminitis, abortions, and fevers. Not all
antibody-positive animals showed clinical signs. These findings show that B.
burgdorferi infection occurs in horses and cows and can cause clinical illness
in some but not all animals. Infection in cows and horses occurs most
frequently 1 month after the emergence of adult I. dammini. Because spirochetes
could be isolated from blood, synovial fluid, colostrum, and urine, these
animals could be important in providing an infected blood meal for ticks and
bringing B. burgdorferi in direct contact with humans.

92162474 Int J Food Microbiol 1991 Dec; 14(3-4): 247-60
Borrelia burgdorferi: another cause of foodborne illness?
Farrell GM, Marth EH
Borrelia burgdorferi was identified as the etiological agent of Lyme disease in
1982. This Gram-negative spirochete is classified in the order Spirochaetales
and the family Spirochaetaceae. The pathogen is fastidious, microaerophilic,
mesophilic and metabolises glucose through the Embden-Meyerhof pathway. A
generation time of 11 to 12 h at 37 degrees C in Barbour-Stoenner-Kelly medium
has been reported. Lyme disease, named after Lyme in Connecticut, is
distributed globally. It is the most commonly reported vector-borne disease in
the United States, where the incidence is highest in the eastern and midwestern
states. Since establishment of national surveillance in 1982, there has been a
nine-fold increase in the number of cases reported to the U.S. Centers for
Disease Control. The deer tick of the genus Ixodes is the primary vector of
Lyme borreliosis. The tick may become infected with B. burgdorferi, by feeding
on an infected host, at any point in its 2-year life cycle which involves
larval, nymphal and adult stages. The infection rate in deer ticks may be as
high as 40% in endemic areas. The primary vertebrate reservoirs for Ixodes are
the white-footed mouse (Peromyscus leucopus) and the white-tailed deer
(Odocopileus virginianus). Dairy cattle and other food animals can be infected
with B. burgdorferi and hence some raw foods of animal origin might be
contaminated with the pathogen. Recent findings indicate that the pathogen may
be transmitted orally to laboratory animals, without an arthropod vector. Thus,
the possibility exists that Lyme disease can be a food infection. In humans,
the symptoms of Lyme disease, which manifest themselves days to years after the
onset of infection, may involve the skin, cardiac, nervous and/or muscular
systems, and so misdiagnosis can occur.

Journal of Spirochetal and Tick-Borne Diseases 1998; 5(4):54-62
Evidence for in utero Transmission of Borrelia burgdorferi from Naturally
Infected Cows
Leibstein MM, Khan MI, Bushmich SL
http://www.medscape.com/SLACK/JSTD/1998/v05.n04/std0504.02.leib/pnt-std050
4.02.leib.html (excerpts from the abstract: Five of 15 adult cows were
spirochetemic at parturition; 4 of the calves from these cows were also
spirochetemic at birth (PCR). Spirochetes were cultured from the placentas in 2
of 10 cows and from the uterine fluid in 1 of 8 cows. Borrelia burgdorferi DNA
was detected in the colostrum in 4 of 12 cows. Three of 15 calves were
stillborn; Borrelia burgdorferi DNA was detected by PCR in 3 of 3 and
spirochetes cultured from 2 of 3 stillborn calves. Fetal tissues from which
Borrelia burgdorferi DNA was detected include blood, spleen, bladder, kidney,
synovial fluid and tissue, heart, cerebrum, and aqueous humor. Borrelia
burgdorferi was cultured from the spleen of one stillborn calf and the kidney
of another. Detection of Borrelia burgdorferi DNA from the tissues of stillborn
calves, as well as spirochetemia in neonatal liveborn and stillborn calves,
gives evidence for in utero transmission of Borrelia burgdorferi in naturally
infected dairy cattle.)

Last, a splenectomized mice study, yet unpublished, but Sousan Altaie very
kindly provided me with her draft text, and she has allowed me to refer to her
data, as stated to me in a mail per 28-03-00:

Marie,
... If you like you may refer to my work as personal communication,
unpublished data. You may also refer to the two published abstracts. ...
Sousan

Transmission of Borrelia burgdorferi from Experimentally Infected Mating Pairs
to Offsprings in a Murine Model.
Altaie SS, Mookherjee S, Assain A, AL-TAIE F, Nakeeb SM, SAEEDA Y. Siddiqui SY

Departments of Pediatrics and Pathology, State University of New York at
Buffalo and The Children's Hospital of Buffalo, NY.

abstract:
The current literature on B. burgdorferi=s mode of transmission in animal
models supports only transmission of the organism by an infected tick bite. In
an effort to develop a murine model for studying other modes of transmission of
B. burgdorferi, we started with the well studied C3H/HeJ mouse. Abzug et al.
has shown that splenectomy increases the in utero transmission of enteroviruses
in a murine model. Splenectomized 6-8 week-old mice were divided into 4 groups.
Groups A, B, and C had 23, 24, and 26 mating pairs respectively. Immediately
prior to mating, in group A only females, in group B only males, and in group C
both females and males were infected subcutaneously with 106-107 B. burgdorferi
in 250 ml SKB II media. The control group D had 12 mating pairs in which both
male and females received sterile SKB II as placebo. The resulting pups were
sacrificed at 1, 7, 14, and 21 days of age. The milk content of the stomach,
sections from ear, skin, heart, liver, spleen, brain, bladder, and kidney of
the 1, 7, and 14 day-old pups were cultured for B. burgdorferi. The cultures
were read at 3, 6, and 9 weeks post incubation. The above mentioned tissues
except milk were also cultured from sacrificed 21 day-old weanlings.
Transmission to offsprings was indicated when B. burgdorferi was isolated from
any tissue from a given pup. From the experimentally infected females in which
the milk was cultured ( total 25 females in groups A and C), 2 (8%) transmitted
B. burgdorferi to their pups on day one via their milk: 2 pups from a litter of
4 in group C, 1 pup from a litter of 8 in group A. No transmission was detected
via milk on days 7 or 14. Among 49 infected females from groups A and C, 5
(10.2%) transmitted B. burgdorferi to their pups either in utero or
intrapartum. Two of the transmissions were detected on day 1 ( litter one, 2/6;
litter two, 1/7), two on day 7 (litter three, 1/7; litter four, 2/6), and one
on day 14 (litter five, 2). Interestingly, four of the litters from the mating
pairs in group B had infected pups (litter one, 3/5; litter two, 1/8; litter
three, 3/6; and litter four, 2/4). These results indicate that B. burgdorferi
can be transmited by other modes besides the tick bite in speenectomized mice.
The described mouse model with further modifications may provide a tool for
studying such transmission modes and treatment strategies.

These modes of transmission only serve to increase the methods which
Borrelia burgdorferi infections can be contracted and in some cases the
tick-vector does even have to be present. This raises the number of
people who are contracting Borrelia infection via other routes and through
other sources of infection.

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