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So what is Lyme Disease and why should I be Concerned?

As a follow-up to our previous blog post by CRCA biologist Tom Beaubiah, we conducted a Q&A session with two experts on ticks and Lyme Disease from KFLA Public Health – Adrienne Hansen-Taugher and Joan Black.

CRCA – So what is Lyme Disease?Tick identification

ADRIENNE – It’s a bacterial infection called barrelia burgdorferi, and it’s transported by the black-legged tick, which is the only way for humans and animals to get it.

It was first discovered through an outbreak of juvenile arthritis in Lyme, Connecticut in the late 1960s. They had this group of kids that all of a sudden developed arthritis for no apparent reason. And lo and behold it turned out to be what we now call Lyme Disease.

When you look at its evolution, you see that it worked its way through Maine, Connecticut, Vermont and migrated north through the 1000 Islands to where it is now. We started to see the first human cases here about a decade ago. I remember dealing with a Lyme Disease case when I was a nurse on the communicable diseases team and that would have been in the early 2000s. At the time it was sort of a one-off, but it was the first time we had a case of it where the person hadn’t come from the USA.

Now we are in a situation where, in 2014, we have roughly 14.5 human cases per 100,000 people in KFLA, whereas overall in Ontario it’s 1.1 cases per 100,000. So we have a much higher incidence of Lyme Disease in this area. We’ve had 26 confirmed cases in total for 2014.

CRCA – How does Lyme Disease manifest itself, what are its symptoms and how do those symptoms progress over time?

JOAN – We divide it into three phases. The early phase is called ‘early localized disease’ and that’s between three and 30 days. In that time, a person might have a fever, headache, sore muscles and joints and an expanding red rash that sometimes clears and looks like a bullseye – that’s why it was originally called a bullseye rash.

Between 30 days and three months, that’s called ‘early disseminated disease.’ If the person hasn’t had a successful course of antibiotics they can go to this second stage which can lead to multiple spreading rashes, fever, headache and swollen lymph glands. At that time it could also affect the heart muscle and you could develop some neurological symptoms such as facial palsy.

And then the third stage is ‘late disseminated disease,’ and that happens when you haven’t been treated and you’re over three months into the bacteria spreading. That’s when it is commonly presented as arthritis, which can be pretty painful and debilitating. It usually hits the knees but can also involve the elbow or wrist. And you also see more facial nerve palsy at this stage as well.

CRCA – To reiterate what Tom talked about last time, what are the ways to avoid getting infected with Lyme Disease?

ADRIENNE – In some ways it’s like when we talk about sun safety. We’re not telling people not to go outside and enjoy nature and the conservation area. We want to encourage it, but you need to take the appropriate precautions, just as you would to protect yourself or your family from the harmful rays of the sun.

Do a tick check!One thing is to wear insect repellant that is effective against ticks, and most importantly do a tick check after you’ve returned from outside.

I know some people who have instituted a tick check at the end of the day after being at the cottage, making sure there are no ticks attached to their clothing or skin. The other thing is if you come inside and you know you’ve been around areas where ticks may be, it’s a good idea to shower within a couple of hours to help remove ticks that haven’t attached to your skin yet. At the same time, you can check to see if any have attached themselves.

The other thing we tell people is if they are living in a more rural area, or even if you have treed areas with long-grass borders, to try and create a one-metre wide boundary between your recreation area – so your lawn essentially – and the treed, grassy area using something like mulch chips.

CRCA – And sometimes people forget about their pets and how ticks can be harmful to them, as well as be spread by them.

ADRIENNE – That’s another big thing to consider. You have to make sure you are checking your pets for ticks because they can bring them indoors. And this is another reason why people need to stay in the middle of the trails, especially if they have their dogs with them.

CRCA – What final message do you have for the folks reading this blog?

ADRIENNE – When you are checking for ticks, that’s not when you’re going to be symptomatic. If you notice signs and symptoms, like you have a rash or otherwise unexplained fever, especially in the summer, you do need to see your health care provider. That’s another one of our key messages – seek help early.

If someone has a tick that has been attached to them for more than 24 hours and they have it removed within the last 72 hours, they should talk to their physician about preventative antibiotics. A single dose can help prevent Lyme Disease if its within that time frame.

And there are a lot of silly myths out there about removing ticks, like you should burn them off or smother them. The thing people have to understand is that the bacteria is in the tick’s belly, and if you ‘tick off’ the tick it will regurgitate that into your body, so you are actually increasing your risk of being infected by trying to burn it off or some other silly method. The best way is to just straight up remove it.

Tick RemovalAnd don’t go digging around trying to remove it because you could end up creating a secondary bacterial infection. Once the body of the tick is gone the threat of Lyme Disease is gone. And what’s left behind is simply like a splinter – your body will push it out on its own. We just use fine-tipped tweezers, grasping it close to the skin as possible and just use gentle, steady pressure upwards to remove it.

For more information on ticks and Lyme Disease, or any other public health concerns, visit www.kflapublichealth.ca.

Adrienne Hansen-Taugher is the Manager, Communicable Diseases and Emergency Preparedness for KFLA Public Health.
Joan Black is Public Health Nurse, Communicable Disease Team for KFLA Public Health.

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