The truth about Lyme disease

Source: Best Health Magazine, Summer 2012

Ten years ago, while gardening at her cottage in St. Donat, Que., Dr. Maureen McShane felt something on the back of her knee. She brushed it off and thought nothing more of it. Within weeks, she started to experience joint, muscle and neck pain. She endured 10 months of declining health, fatigue, decreased mobility and memory loss’and many fruitless medical visits and misdiagnoses. One day a patient visited her for a renewal of antibiotics he had been given by another doctor to treat Lyme disease. His symptoms were remarkably similar to hers. She visited her patient’s doctor and got the diagnosis: Lyme disease, thanks to being bitten by an infected tick when she was gardening that day.

After two years on antibiotics, McShane says she has recovered to about 95 percent of her former health. A Montreal resident whose medical practice is over the border in Plattsburgh, N.Y., McShane has dedicated herself to treating patients with Lyme disease. ‘When I was sick, I felt abandoned by medicine. If a diagnosis of Lyme disease is missed, it takes years of antibiotics to get rid of rather than weeks.’

Early diagnosis and treatment is all the more important given ticks’ invasion of Canada. The first cases of Lyme disease in this country started showing up in the early ’90s as the disease made its way from the U.S., arriving first on the shores of Lake Erie and in southern British Columbia. Since then, it has crept into southeastern Manitoba; southern and southeastern Quebec; southern and eastern Ontario; New Brunswick; and Nova Scotia. And it shows no signs of slowing down. ‘The tick population is moving north into Canada at a rate of about 35 to 55 kilometres a year,’ says Nick Ogden, a veterinarian and senior research scientist in the zoonoses division at the Public Health Agency of Canada (PHAC), and lead author of the 2009 paper ‘The Emergence of Lyme Disease in Canada.’ A recent PHAC study predicts that by 2020, 80 percent of eastern Canada’s population will live in an area where Lyme-infected ticks are found; that figure sits at 18 percent today.

It’s difficult to say how many human cases of the disease exist in Canada. Lyme disease became a nationally reportable disease in 2010, but Ogden says there is not yet enough data for an accurate accounting.

So what do you need to know to protect yourself and your family? Read on.

What is Lyme disease?

The ticks are merely the messenger: Lyme disease is caused by the bacterium Borrelia burgdorferi. Ticks pick it up by feeding on the blood of infected mice, squirrels, birds, deer and other animals (the disease tends to have a lesser effect on these animals; however, infected dogs can experience joint pain and lameness). Unfortunately, ticks like to feed on humans, too. ‘They use an ambush strategy,’ says Ogden. ‘They sit on blades of grass and twigs, waiting for an animal or human to brush by, and then they jump on and feed.’

To complicate matters, you rarely feel them bite. ‘Ticks can be as small as a poppy seed, and as large as five or six millimetres in length when engorged after a blood meal,’ says McShane. ‘And they will attach anywhere’eyebrows, scalp, folds of skin, back of knees, and the groin.’

Symptoms

The first sign of acute Lyme disease is often a target-shaped rash called a bull’s eye or erythema migrans rash. It shows up from three days to a month after the bite, and can appear at the bite location or other locations as bacteria travel through the body. ‘Not everyone gets a rash,’ notes McShane. Other common symptoms include fatigue, flu-like symptoms (fever, aches, chills, nausea), headache, and travelling muscle and joint pain, says McShane, who cautions not to assume you have the flu, especially if it’s not flu season.

Once you start experiencing any of these symptoms, treatment with antibiotics is essential for a quick recovery; otherwise, arthritis, organ damage and mobility issues can result. There are blood tests for Lyme disease, but they are not 100 percent accurate (see ‘The Debate Over Testing,’ right). Ask your doctor if you should start a course of antibiotics before test results come back.

Be tick aware

You don’t need to forgo enjoying the outdoors. Protecting yourself from ticks is very similar to how you would prevent mosquito bites.

Wear long-sleeved shirts, long pants, socks and closed-toe shoes when in woody or grassy areas. Tuck pants into socks. Choose light colours so you can see ticks if they crawl on you.

For adults and children over 12, apply insect repellent containing up to 30 percent DEET. Make sure to read and follow label directions.

For children age two to 12, apply insect repellent containing no more than 10 percent DEET up to three times daily. Avoid prolonged use of DEET products, though, for children under 12.

For children six months to two years, use repellent with no more than 10 percent DEET, no more than once daily. Do not use DEET products on infants under six months of age. Instead, use a mosquito net when they are outdoors in strollers or portable cribs.

Carry fine-tipped tweezers with you for tick removal, advises Jim Wilson, president and founder of the Canadian Lyme Disease Foundation, who contracted the disease in 1991 but went undiagnosed for several years.

Stay out of tall grass and be careful when gathering wood or hiking. When you’re on wilderness trails, stay in the centre of the path and avoid brushing up against plants.

Do a daily tick check on yourself, your kids and pets; removal of ticks within 18 to 24 hours of attachment can reduce the risk of infection. Not sure what you’re looking for? See the photos on canlyme.com.

Don’t allow outdoor pets’and especially those that spend time in the country or large wooded parks’on your bed, in case they are carrying ticks.

Once bitten

Found a tick? Take a breath and get some fine-tipped tweezers. Grasp its head as close to your skin as you can (try not to squeeze the body, as it can release the bacterium). Pull slowly; don’t twist as you pull and don’t touch the tick with your fingers, says McShane. Afterwards, wash the area with soap and water, alcohol or antiseptic. Save the tick in an airtight container to take to your doctor for testing for Lyme disease as well as co-infections that can also be passed on to you through a bite.

This article was originally titled "Lyme time" in the Summer 2012 issue of Best Health. Subscribe today to get the full Best Health experience’and never miss an issue!