Committee Opinion No. 399: Management of Tick Bites and Lyme Disease During Pregnancy

TitleCommittee Opinion No. 399: Management of Tick Bites and Lyme Disease During Pregnancy
Publication TypeJournal Article
Year of Publication2020
AuthorsSmith GN, Moore K, Hatchette TF, Nicholson J, Bowie W, Langley JM
JournalJ Obstet Gynaecol Can
Start Page644
Date Published05/2020
Keywordsborrelia burgdorferi, infection, Lyme disease, pregnancy, ticks

Lyme disease is an emerging infection in Canada caused by the bacterium belonging to the Borrelia burgdorferi sensu lato species complex, which is transmitted via the bite of an infected blacklegged tick. Populations of blacklegged ticks continue to expand and are now established in different regions in Canada. It usually takes more than 24 hours of tick attachment to transfer B. burgdorferi to a human. The diagnosis of early localized Lyme disease is made by clinical assessment, as laboratory tests are not reliable at this stage. Most patients with early localized Lyme disease will present with a skin lesion (i.e., erythema migrans) expanding from the tick bite site and/or non-specific "influenza-like" symptoms (e.g., arthralgia, myalgia, and fever). Signs and symptoms may occur from between 3 and 30 days following the tick bite. The care of pregnant patients with a tick bite or suspected Lyme disease should be managed similarly to non-pregnant adults, including the consideration of antibiotics for prophylaxis and treatment. The primary objective of this committee opinion is to inform practitioners about Lyme disease and provide an approach to managing the care of pregnant women who may have been infected via a blacklegged tick bite.