Lyme Disease

To the Editor: Dr. Steere briefly addresses the important question of prophylactic antibiotic therapy for deer-tick bites in his superb review of Lyme disease (Aug. 31 issue).¹ Others have offered the opinion that only attachments by engorged deer ticks warrant treatment.² Although it is believed that Borrelia burgdorferi is transmitted mainly in the later stages of tick feeding,^{3 4 5} the earlier transmission of small numbers of the organism has not been ruled out. Ribeiro et al.³ were unable to procure sufficient saliva for examination before three days of attachment, after which spirochetes were seen. We do not know the minimal inoculum.