Beware: Lyme Disease Threatens Us All

Canada has recently seen an increase in black-legged ticks, and with those ticks comes an increase in cases of Lyme Disease.

In 2017, Ontario alone reported 1000 cases of Lyme Disease, compared to 400 cases reported in 2016.  Statistics show that Lyme Disease has more than doubled in the province of Ontario, and that’s only based on reported cases. Many more cases go undiagnosed and unreported.

Do you travel to the Pinery Provincial Park or Grand Bend on Lake Huron, or Turkey Point or Long Point on Lake Erie? Niagara Falls, Pickering, Thousand Islands? These are all risk areas for contracting Lyme Disease in Ontario, and there are many more. We all need to be aware of the causes, symptoms, and treatment for this disease that threatens all of us.

We have climate change to blame for one more thing: the resilience of the black-legged tick that is responsible for Lyme Disease. In the past, people only needed to be vigilant in warm, wet areas of the U.S., but warmer temperatures have allowed this tiny beast to survive north of the border and the people of Ontario need to know.

Black-legged ticks are the main carrier of Lyme Disease. They carry a bacterium known as borrelia burgdorferi, also known as the Lyme Disease bacterium. They find skin of both animals and humans to attach to, then burrow into the skin and infect the blood.

Staying vigilant around certain areas is key to avoiding the disease entirely. If you live, work, or just happen to be around woodland areas, especially around long, unattended grass, you’re at risk of attracting ticks. Black-legged ticks like to hide in the long grass and hop onto any free skin. To keep yourself from getting ticks in the first place, it is recommended that you wear long clothing, such as pants and long-sleeved shirts. Insect repellent works marginally against ticks, and recently the smell of garlic has been proven to repel ticks.

If you happen to be wearing bathing suits, or t-shirts and shorts, and have to walk through long grasses, have someone check you for tiny black dots that may be ticks once you leave the grassy area. Be sure to thoroughly check both children and pets as well.

To remove a tick, pinch the little black dot and pull it straight out. Do not throw the tick away. Put the tick into a sealed bag or container to take to your local public health unit, where it can be checked for the bacteria.

Early diagnosis is important in curing the disease.  So getting to know the symptoms is very beneficial. Watch for the following:

  • A big red rash shaped like a bull’s eye, AKA the bull’s-eye rash
  • Fever
  • Headache
  • Muscle and joint pains
  • Spasms
  • Numbness or tingling
  • Facial paralysis
  • Fatigue
  • Swollen glands
  • Expanding skin rash (however, many people never get or see a rash)

People with Lyme Disease report having some or all of these symptoms. And they also talk about the way symptoms change from one month to the next.

One problem with Lyme Disease is diagnosis. Physicians, doctors, naturopaths and other specialists all have different methods and technologies for testing for Lyme Disease. Some testing methods are inaccurate and outdated.  “Infected individuals initially experience flu-like symptoms. Left untreated, the disease can affect the skin and internal organs as well as the musculoskeletal system, and impair eyesight and hearing,” reports the University of Guelph’s testing labs. “It’s one of the most commonly misdiagnosed diseases, with symptoms that mimic other diseases such as multiple sclerosis, amyotrophic lateral sclerosis, and Alzheimer’s and Parkinson’s disease.”

Dr. Erika Holenski, N.D., naturopath at KW Health Connection, has treated many patients over the past ten years who have symptoms of Lyme Disease. She has worked to diagnose and help many patients with Lyme Disease that otherwise would go undetected. I was lucky enough to talk to her about the disease and how it is slowly increasing throughout Ontario.

I asked Dr. Erika what people should do if they have been bitten by a tick.

“If they suspect they have been bitten by a tick they should document everything they are feeling, (eg.  fever, chills, joint pain, body aches, rashes). They should take pictures and measure any rashes that may occur. And they should document when and where they think they were bitten.  If they see a tick, they should save it so it can be tested. Then they should see a doctor and relay all of the above information.”

Many cases of Lyme Disease go undiagnosed so I asked Dr. Holenski about this issue.  “Diagnosis can be tricky as there is controversy regarding certain tests. Generally, as a Naturopath, I use IgeneX labs based in California or Armin labs based in Germany.  Both of these labs will test blood samples. For very long-standing chronic cases, I also use a Pathogen Panel by Cyrex labs. A GP in Ontario, in my experience, uses the lab test via Ontario Public Health. 

I am finding most people will see their GP and get the Ontario test as well as see a Naturopath and receive blood analysis from one of the above listed labs.”

I was curious about the fact that so many people get testing done outside of Canada and wondered why Dr. Holenski uses laboratories outside of Canada.  She replied that “the testing methods are different outside of Canada. As with everything, technology, research and education has advanced, and the tests outside of Canada reflect this.”   

As I researched LD and read patients’ stories, it seemed to me that there are many more cases occurring than are reflected in reports from our regional health unit.  I asked Dr. Holenski if this perception was valid. “In my experience, the regional health unit reports a positive based on the Ontario test or a letter from the patient’s GP with their diagnosis.  There was a letter written in 2016 (or 2017) by the Ontario Health Minister reminding that according to Standards of Practice, Lyme Disease is a diagnosis of medical history, and signs and symptoms, and does not need to have a positive Ontario blood test.” 

That means our regional health unit should be reporting positive blood tests done anywhere as long as the bite occurred in Ontario.

https://www.ofah.org/wp-content/uploads/2016/08/minister-letter-to-docs-re-lyme-2016-07-29_english.pdf

Further research led me to the Region of Waterloo Public Health. I called them to ask them some questions, and a few days later, one of their representatives, Maliha Ahmed, was able to get back to me with some research and data for my questions.

1)   How many cases of Lyme Disease are reported annually in the Region of Waterloo? 

“As stated in the Vector-Borne Disease Program Summary, in 2017 there were seven cases of Lyme disease (confirmed or probable) reported to Public Health, where all of these cases were acquired outside of Waterloo Region (Region of Waterloo Public Health and Emergency Services Health Protection and Investigation, 2018).”

Ahmed attached a link to Public Health Ontario where people can see reportable disease trends including those for Lyme Disease in Waterloo Region and across Ontario.

https://www.publichealthontario.ca/en/data-and-analysis/infectious-disease/reportable-disease-trends-annually#/34

2) Where do people go if they want to be tested for Lyme Disease?

“If an individual would like to be tested for Lyme Disease, they will need to speak to their physician about obtaining a blood test to indicate a specific antibody response. In the Region of Waterloo and Ontario, testing is readily conducted by Public Health Ontario laboratories when requested by a doctor.”

3) Research has shown people from Waterloo Region travel to American labs for testing for Lyme Disease. If they have a positive result would that be recorded here at our regional health unit?

“Results from any lab tests including those conducted outside of Ontario should be discussed with a physician. Physicians typically review results of lab tests together with clinical symptoms of Lyme disease when formulating a diagnosis.”

4) Overall do you feel like the public should be concerned about the increasing number of Lyme Disease cases in the region?

“The members of the public should discuss any concerns with their family doctor. Currently there is much more awareness surrounding Lyme Disease than in the past which makes early case detection and management possible.

The Region of Waterloo Public Health offers tick identification services and arranges for the testing of black legged ticks for the bacteria that causes Lyme Disease. Additionally, Public Health conducts vector surveillance and human case surveillance such as patient follow-up, with a larger focus on prevention through education and awareness campaigns (Region of Waterloo Public Health and Emergency Services Health Protection and Investigation, 2018).”

If it wasn’t already clear, Lyme Disease is a very debilitating and life-altering illness. It is not to be taken lightly, and anyone who experiences symptoms, or finds a black-legged tick on them or their pets, should seek help immediately.

References

Public Health Ontario. (2019a, October 22). Lyme Disease – Serology. Retrieved from https://www.publichealthontario.ca/en/laboratory-services/test-information-index/lyme-disease-serology

Public Health Ontario. (2019b, April). Ontario Lyme Disease Map 2019 Estimated Risk Areas. Retrieved from: https://www.publichealthontario.ca/-/media/documents/lyme-disease-risk-area-map-2019.pdf?la=en

Region of Waterloo Public Health and Emergency Services Health Protection and Investigation.         (2018, March 20). Vector-Borne Disease Program Summary (Report No. PHE-HPI-18-      02). Retrieved from https://calendar.regionofwaterloo.ca/Council/Detail/2018-03-20-1100-Community-Services-Committee/03747232-f117-484a-a0ee-a8a900f48b89

Service, U. G. N. (2017, June 15). $1.4-Million Grant to Fight Lyme Disease Honours Memory of Magnotta Winery Founder. Retrieved November 21, 2019, from https://news.uoguelph.ca/2017/06/lyme-disease-grant/.