The pathophysiology of Borrelia burgdorferi, the
Lyme disease spirochete, is unique in tick/vector relationships, differing substantially from that of other spirochetes, e.g., Borrelia duttonii, the agent of tick-borne relapsing fever, and Borrelia recurrentis, the agent of louse-borne relapsing fever, in their respective vectors. Following ingestion by a tick, B. burgdorferi lodges in the midgut diverticula, in some instances penetrating the gut wall and invading various tissues. Certain investigators suggest that transmission of the spirochete occurs via infectious saliva, although, in light of the fact that only 5% of adult ticks are systemically infected, this mechanism is open to question. Alternatively, transmission may occur via periodic regurgitation of gut fluids during the feeding process. While ticks of the genus Ixodes were once thought to be the only vectors, it now appears that other genera, and possibly other hematophagous arthropods, may also be involved.