Experts have been warning for years that an outbreak Lyme disease isn’t as unlikely as previous generations have thought, and recent reports and incidents are beginning to add up.
While the spread of Lyme disease has been more drastic in North America, it has steadily spread to 80 countries worldwide, reports Global News’s Melanie de Klerk. But not only is the reach of the disease concerning, its sudden increase in occurrence has begun to factor into doctors’ diagnostic considerations, causing them to revaluate whether Lyme disease should be last on the list of possibilities or one of the first.
The Public Health Agency of Canada documented 1,479 cases of Lyme disease across Canada in 2017. This is significant as it was nearly 50 percent higher than the number of incidents in 2016. According to Public Health Ontario, the province alone saw 1,003 cases of Lyme disease between 2012-2016. Much like the country at large, the province’s numbers are also predicted to increase.
According to the Mayo Clinic, Lyme disease is caused by bacteria carried and transmitted by ticks — in particular, black-legged ticks, colloquially known as deer ticks. These ticks are known for carrying Borrelia burgdorferi and Borrelia mayonii in the United States and Canada, while two other strains of bacteria carried by ticks spread Lyme disease in Europe and Asia.
The Mayo Clinic goes on to say that many smaller, brown ticks are almost impossible to detect, meaning that they sometimes go unnoticed while transmitting the disease, which usually takes over 48 hours.
The main risk factors include spending time in wooded or grassy areas, having exposed skin, and not removing ticks promptly or properly.
They further explain that untreated Lyme disease often causes chronic joint inflammation (Lyme arthritis), particularly of the knee; neurological symptoms, such as facial palsy and neuropathy; cognitive defects, such as impaired memory; and heart rhythm irregularities.
As Dr. Kieran Moore, the principal investigator with the Canadian Institute of Health Research-funded Canadian Lyme Disease Research Network, explains, “Once you miss the opportunity to treat it acutely, the bacteria can disseminate from the site of tick bite.”
“It can be spread to your joints and cause rheumatological Lyme,” he continued, “or it can spread into nerve tissue and cause nerve tissue damage, or it can attach to the muscle of the heart and the nerve conduction system of the heart and cause all types of different cardiac presentations.”
Barry Philpot, a Lyme disease patient who didn’t understand or handle his symptoms until they were serious, described his experience: “I just kept deteriorating with really weird heart palpitations and cognitive issues like [being] unable to concentrate, slurred speech, trouble swallowing, light sensitivity, sound sensitivity and just a rapid deterioration to the point where I had to come home from work.”
According to the Centers for Disease Control and Prevention in America (CDC), roughly 30,000 Lyme disease cases are reported by state health departments and the District of Columbia each year. However, they postulate the actual number is nearly 10 times that when other methods, besides state health department reports, are considered.
The CDC reports that 42,743 confirmed and probable cases of Lyme disease were reported to CDC in 2017. This figure represents a 17% increase in just a year. Over 9 years, the number of cases has increased from 324 in 2008 to 454 in 2017 per 100,000 people.
The concentration of Lyme disease seems to be in America’s northeastern states, particularly those around large bodies of water like the great lakes. The highest rate of the disease, however, was in Maine.
Much like the U.S., Lyme disease risk areas are concentrated in eastern provinces, far more so than in B.C. or Alberta. Major cities in the eastern provinces and the rural areas surrounding them are particularly susceptible.
With that spread, the CDC warns that Lyme disease is spreading throughout the country, much like it is spreading throughout Canada.
According to Dr. Kieran Moore, there are two main problems which is contributing to Lyme disease being under-treated before it gets serious: tests which are not completely reliable, and doctors considering all other possibilities before considering Lyme disease.
“We need significant work to educate physicians both in the front lines — emergency medicine and primary care — as well as our specialist colleagues regarding the myriad of signs and symptoms that Lyme disease can present as,” said Moore.
“We know that the current diagnostic tests for Lyme disease are insensitive,” he added. “If someone presents in June, July or August just with undifferentiated fever, chills, muscle aches, headaches, neck stiffness… think Lyme disease.”
Both Dr. Moore and investigative journalist Mary Beth Pfeiffer, who has intensely followed Lyme disease outbreaks after her own community was affected, both believe that climate change is a major contributing factor in the spread of the disease, as the ticks carrying the disease thrive in hot and humid climates.
Moore believes that awareness and education are the first tools at our disposal to combat the spread of Lyme disease, as well as preventative measures such as wearing light-coloured clothing when camping so that ticks are more visible and using tick repellent. Better testing methods are also needed, Moore says, but the push for improvements may also come down to public awareness and a public push.