Lyme Disease

Unlike in eastern Canada, the rate of Lyme disease has remained low in BC. Page Content. tick. The infection is preventable by avoiding tick bites and removing ... 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Menu HealthInfoDiseases&ConditionsLymeDisease(Borreliaburgdorferiinfection) SHARE A A Lymediseaseisthemostcommontick-bornediseaseinBCandNorthAmerica.UnlikeineasternCanada,therateofLymediseasehasremainedlowinBC. PageContent  Theinfectionispreventablebyavoidingtickbitesandremovingattachedticksearly.Earlydiagnosisand antibiotictreatmentare importantbecauseLymediseasecanleadtoseriouscomplicationsifleftuntreated.Informationforhealthprofessionals Howtosubmitatickfortesting CasedefinitionforLyme LaboratoryTesting LymeDiseaseinBC LymediseaseiscausedbyabacteriumcalledBorreliaburgdorferiwhichisspreadbyticks. B.burgdorferihasbeenfoundintwospeciesofticksinBC: Ixodespacificusand Ixodesangustus,alsoknownaswesternblack-leggedticks.   Ticksaretinybugsaboutthesizeofsesameseeds,thatfeedonblood.TheticksinBCprefertogettheirbloodmealfromrodentsandsmallanimals.Sometimesatickwillbiteapersonaccidentallyinsteadofbitingananimal.Whilemosttickbitesdonotresultindisease,somedo. IxodesticksaredistributedthroughoutBC.However,mostticksthatcarryLymediseasearefoundinsouthwesternBC,includingVancouverIsland,theGulfIslands,theSunshineCoast,GreaterVancouver,andtheFraserValley.ThegeographicdistributionofLymediseaseinpeopleandinticksinBChasremainedconstantovertime. InBC,lessthan1percentoftickstestedcarrythebacteria B.burgdorferithatcauseLymedisease.Althoughthenumberoftickssubmittedfortestinghasincreasedinrecentyears,theprevalenceof B.burgdorferiintickshasremainedconsistentlylowovertime.(Seethechart). Ticksliveintallgrassandforestedareasandattachtopeopleoranimalsastheypassby.Ticksburrowpartwayintotheskin,bite,drawblood,andthendropoff.Tickscanbefoundyear-roundbuttheyaremostlikelytobiteinthespring(fromMarchtoJune). TheriskofLymediseaseinBCislowerandmorestablethanitisineasternandcentralCanadaandinthenortheasternUSA.Intheseregions,Lymediseaseratesinhumansandtickshaveincreasedwithclimatechange.Reasonsforthisdifferenceinclude: •TheticksspeciescapableofcarryingLymediseaseinBCaredifferent. I.pacificusand I.angustus(westernblack-leggedticks)arelesscapableofcarrying B.burdorferithan I.scapularis(black-leggedtick),thetickineasternCanada. •Theanimalsonwhichticksfeedaredifferent.InBC,ticksfeedonsmallrodentssuchasdeermiceanddusky-footedwoodrat.IneasternCanadaandtheUSA,ticksfeedonwhite-footedmiceandwhite-taileddeer. •ThevegetationandclimatearedifferentbetweenBCandeasternCanada(e.g.BChasmostlyconiferousforests,whereaseasternCanadahasmostlyleafyforests). •IxodesticksarepresentthroughoutsouthernandcentralBC,includinginmostofthehighlypopulatedareas.Anexpansionoftherangeoftheseticks,whichcouldoccurwithclimatechange,willnotgreatlyincreasethenumberofpeopleexposedinBC. Symptoms Ifyouhavethefollowingsymptomswithin3-30daysafterbeingbittenbyatickorafterhavingbeenintallgrassyorwoodedareasknowntohaveLymedisease, consultyour healthcareprovider.Tellyourdoctorwhenandwhereyouwerebittenbyatick.Skinrash:About70-80%ofpatientshaveaskinrashatthesiteofthetickbite.Therashfeelswarmbutisnotitchyorpainful.Itexpandsoverafewdaysandcanreachupto30cmacross.Partsoftherashmayclearasitenlarges,resultingina“bull's-eye”appearance.Thisiscallederythemamigrans.Somepeoplemaynotexperiencearash.  feverheadachemuscleandjointpainsfatigueweaknessorparalysisofthemusclesoftheface   Diagnosis Lymediseaseisdiagnosedbasedonsymptoms,aphysicalexam,thepossibilityofexposuretoinfectedticksandlaboratorytesting.IfyourhealthcareprovidersuspectsLymedisease,youmaybeaskedtoprovideabloodsamplefortesting.LaboratorytestingisnotrecommendedforpatientswhodonothavesymptomsconsistentwithLymedisease. Laboratorytestssupportclinicalcarewhenusedcorrectlyandareperformedusingvalidatedmethodsinanaccreditedlaboratory.InBC,laboratorytestingtodiagnoseLymediseaseisdonebytheBCCDCPublicHealthLaboratory(PHL),alaboratoryaccreditedbytheCollegeofAmericanPathologistsandtheDiagnosticAccreditationProgram.BCCDCPHLfollowstheUSCentersforDiseaseControl&PreventionandPublicHealthAgencyofCanadarecommendedprocesstoassessforevidenceofantibodiesagainsttheLymediseasebacteria. Bloodtests maynotbepositiveinearlyinfection.Therefore:SymptomsofearlyLymedisease(e.g.rash)followingtickexposuremaybetreatedbyyourhealthcareprovideronclinicalgrounds,evenwithoutapositivetest.Repeattestingafewmonthsafteraninitialnegativetestmaybewarrantedifthereareongoingsymptoms. Treatment ThegreatmajorityofpeoplewithLymediseasecanbetreatedsuccessfullywith2-4weeksofantibiotics,especiallyifcaughtearly.  Complications   Aftermonthsoryears,peoplewithLymediseasewhowerenottreatedmaydevelopcomplications.About60%ofuntreatedpatientshaveboutsofarthritis,withseverejointpainandswelling.Largejointsaremostoftenaffected,particularlytheknees.Upto5%ofuntreatedpatientsdevelopchronicneurologicalcomplaints.Theseincludeshootingpains,numbnessortinglinginthehandsorfeet,andproblemswithshort-termmemory.    About10-20%ofpatientswithLymediseasehavesymptomsthatlastmonthstoyearsaftertreatmentwithantibiotics.Thesesymptomscanincludemuscleandjointpains,cognitivedefects,sleepdisturbance,orfatigue.Thecauseofthesesymptomsisnotknown,butthereisnoevidencethatthesesymptomsareduetoongoinginfectionwithB.burgdorferi.Studieshaveshownthatcontinuingantibiotictherapyisnothelpfulandcanbeharmfulforpeoplesufferingfromthesesymptoms.Researchtoidentifythereasonsforsuchpersistentsymptomsshouldbeahighpriority.    Ifyouhavesymptomssuchasfatigue,pain,poorsleepandproblemswithbrainfunctionandtestnegativeforLymedisease,orpersistentsymptomsaftertreatmentforLymedisease, pleaseconsulttheBCWomen'sHospitalComplexChronicDiseaseProgramforfurthersupport. Lymediseaseinpets Certainanimals,likedogs,horsesandcows,canalsogetLymediseasewithsymptomssimilartothoseseeninhumans.Dogsareparticularlysusceptible.Symptomsmaynotappearfor7-21daysorlongerafteratickbite,sowatchyourdogcloselyforchangesinbehaviourorappetite.Tickbitesondogsmaybehardtodetect.Ifyoufindatickonyourdog,removeitasyouwouldinahuman. Toreducethechancesthatatickwilltransmitdiseasetoyourpets:Checkyourpetsforticksaftertheyspendtimeoutdoors.Ifyoufindatickonyourdog, removeitrightaway.Askyourveterinariantoconductatickcheckateachexam.Talktoyourveterinarianabouttickbornediseasesinyourarea.Talkwithyourveterinarianaboutusingtickpreventivesonyourpet.   Prevention ThereisonlyaverysmallchanceoftickstransmittingLymediseasetohumans.However,thediseasecanbeserious,soitisworthtakingstepstoavoidbeingbitten. Toprotectyourselfagainsttickandinsectbites:Walkonclearedtrailswhereverpossiblewhenwalkingintallgrassyareas,orforestedareas.Wearlightcolouredclothingsoyoucanseeticks,tuckyourtopintoyourpantsandtuckyourpantsintoyourbootsorsocks.PutinsectrepellentcontainingDEETorIcaridinonalluncoveredskinandclothing.Reapplyasfrequentlyasdirectedonthecontainer.Whenleavinganareawhereticksmaybefound:TakeabathorshowertoremovelooselyattachedticksCheckyourentirebodyforattachedticksincludingthescalp,foldsofskin,underthearms,behindtheknees.Havesomeonehelpyoucheckhard-to-seeareas.Ifatickisfound,removeitimmediately(seebelowforinstructions).Checkchildren,petsandoutdoorgearforticks.Putclothinginahotdryerfor10minutestokillanyremainingticks. Tickremoval Themostimportantthingistomakesurethatyouremoveallthetick,includingthemouthpartsthat maybeburiedinyourskin.Also,donotsqueezethebodyofthetickwhenyouareremovingit.Thiscanforceitsstomachcontentsintothewoundandincreasethechanceofinfection.Ifyou findatick: removethetickyourself;getsomeoneelsetoremovethetickforyou(whenyoucan'treachitorseeitclearly);orgetyour healthcareprovider toremoveit.HowNOTtoremoveatick!Somepeoplethinkyoucanremoveatickbycoveringitwithgrease,gasolineorsomeothersubstance.Thisdoesnotwork!Itonlyincreasesthechanceofyougettinganinfection.Holdingsomethinghot(forexample,amatchorcigarette)againstthetickalsodoesNOTwork!Again,thiswillonlyincreasethechanceofaninfectionoraccidentallyburningyourself.Ifyoudecidetoremovethetickyourself,followtheinstructionsbelow. Whenshouldyouremovethetick?Youshouldonlyremovethetickyourself,orgetafriendorfamilymembertoremoveit,ifthetickisnotburiedverydeepintoyourskin.Thefeedingtick'smouthwillbeundertheskin,butthebackpartswillbestickingout. Ifthetickhasbeenonyourskinforlessthantwohours,ithasprobablynothadachancetoburrowintoyourskin.Ifthetickisjustonthesurfaceofyourskin,oronlybitingontotheoutsideskinlayer,youcanremoveitfollowingtheinstructionsbelow. Whenshouldyougetadoctortoremovethetick?Youshouldgotoyourdoctortogetthetickremovedifithasburieditselfdeepintoyourskin.Thisusuallyhappensifthetickhasbeenonyouforseveralhours,orevenadayortwo.Whenatickhasburroweddeepintoyourskin,itisveryhardtoremovethetickwithoutleavingsomemouthpartsbehind,whichcancauseinfection. Howtoremoveatick  Removethetickrightaway(ifpossible,weardisposablegloveswhenhandlinganengorgedtick):Usetweezersorforcepstogentlygetholdofthetickasclosetotheskinaspossible.Don'ttouchthetickwithyourhands.Withoutsqueezingthetick,steadilyliftitstraightofftheskin.Avoidjerkingitout.Trytomakesurethatallofthetickisremoved.Oncethetickhasbeenremoved,cleanthebiteareawithsoapandwater,thendisinfectthewoundwithantisepticcream.Washyourhandswithsoapandwater. Tickidentificationandtesting ThereareseveralwaysforBCresidentstohaveatickidentifiedandtestedforLymedisease:SubmitaphotototheeTickprogramfortickidentificationVisitahealthcare provideriftickisfoundonahumanVisitaveterinarianiftheatickisfoundonananimal 1.SubmitaphotooftheticktoeTick.caTicksfoundbyBCresidentscanbeidentifiedforfreebysubmittingaphotooftheticktoeTick.Thisisthepreferredmethodtohaveticksidentifiedquickly.IfthetickisidentifiedasthetypeoftickthatcancarrytheagentofLymedisease(black-leggedtick),youwillbeprovidedinstructionstokeepthetickinafreezerfor30daysandmonitorforsignsofillness.Ablack-leggedtickneedstobeattachedformorethan18hourstotransmittheagentofLymedisease.Ifsignsofillnessdevelop,seeyourhealthcareproviderimmediately. www.etick.caordownloadtheeTickappfromtheAppStore 2.VisitahealthcareprovideriftickisattachedtoahumanTicksfoundonBCresidentscanalsobetestedforfreeattheBCCDCPublicHealthLaboratoryifsubmittedbyaphysician.Commercialticktestsarenotrecommended.Ifyourdoctorwantstohavetheticktested:Savethetickinacontainerwithatightfittingtop.Dampenasmallcottonballandputitintothetickcontainertokeepthetickalive.AnintactdeadtickmayalsobeidentifiedandtestedforLymediseasebyPCR.Notethegeographiccoordinatesorlocationanddatethetickwasfoundorbiteoccurred. Yourphysicianshouldusethe Parasitologyrequisition,indicatethesourceofthetick(e.g.human,pet,other),thegeographiccoordinatesorlocationthetickwasfoundandthenameandaddressofthepersonbitten.Labelthecontainerwithtwomatchingidentifierstotherequisition.Ticksmustbesubmittedassoonaspossiblebyaphysicianorpublichealthprofessionalto: BCCDCPublicHealthLaboratory Parasitology655West12thAve.VancouverV5Z4R4BCCanada 3.VisitaveterinarianifatickisfoundonananimalTicksfoundonBCanimalscanalsobetestedattheBCCDCPublicHealthLaboratory.Veterinarianswillbecharged$65pertickfortickidentificationandPCRtestingforLymediseaseifitisnotahuman-relatedtick.IfnoLymediseasecarryingtickisidentified,thereisa$30chargefortickidentificationonly.Black-leggedticksmustbeattachedformorethan18hourstotransmittheagentofLymedisease. Inthissection LymeDisease(Borreliaburgdorferiinfection)TickTalkMoreResources  ContentEditor‭[2]‬ ​Relatedcontent BrowsethelatestLymestatisticsMapofLymediseaseriskareasinBCLymediseasesurveillanceformPublicHealthAgencyofCanadaLymediseaseresourcesBCCDCLymediseasebrochureTicksubmissionsbymonthinBCProportionoftickspositiveforB.burdorferiinBC  ContentEditor‭[1]‬ Relatedarticles AnewBorreliaspeciesdiscoveredinBCticksDiagnostictestingforLymedisease:BewareoffalsepositivesSurveillanceforBorreliaburgdorferiinIxodesticksandsmallrodentsinBritishColumbiaLymedisease:Knowledge,beliefs,andpracticesofphysiciansinlow-endemicareasTreatmentandreportingofLymediseaseamongphysiciansinBritishColumbiaLymediseaseinBritishColumbia:Arewereallymissinganepidemic?PhysicianawarenessofLymediseaseinBritishColumbia SOURCE: LymeDisease ( ) Pageprinted: .Unofficialdocumentifprinted.PleaserefertoSOURCEforlatestinformation. Copyright© BCCentreforDiseaseControl.AllRightsReserved.