Lyme disease is caused by bacteria called Borrelia, which are transmitted to humans through the bites of infected blacklegged ticks (also known as deer ticks) mainly of the genus Ixodes. Most infections occur from bites of nymphal stage ticks, which are very small and may go unnoticed. The ticks acquire the bacteria from infected small mammals or birds and then transmit it when they bite humans. Transmission typically requires the tick to be attached for around 36 hours or more. Lyme disease is not spread by touching, kissing, sexual contact, or through air or food. It is primarily spread only through the bite of an infected tick.