Lyme Disease Surveillance In Canada
Lyme disease became a national notifiable disease in December 2009.
Canada continues to monitor the evolving geographic distribution and prevalence of infected ticks and cases of Lyme disease. Therefore, you must report clinically diagnosed or laboratory-confirmed cases to your provincial or territorial public health authorities.
Health professionals in Canada play a critical role in identifying and reporting cases of Lyme disease. See the surveillance section for more information on surveillance in Canada.
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What Happens If Lyme Disease Is Left Untreated
Caused by the bacteria Borrelia burgdorferi, Lyme disease is a bacterial infection spread to humans through tick bites. It is the most common vector-borne disease in the United States. In fact, its possible that there are around 476,000 cases per year in the U.S alone according to statistics from the Centers for Disease Control and Prevention .
A blood test is required to correctly diagnose a suspected Lyme disease case. Without trustworthy testing, Lyme disease cases can go undetected and its possible for people to live with the disease and not realize it – this can cause a number of complications.
Unexplained Pain And Other Sensations
Some people with Lyme may have sharp rib and chest pains that send them to the emergency room, suspecting a heart problem 00090-7/abstract%20″ rel=”nofollow”> 27).
When no problem is found, after the usual testing, the ER diagnosis is noted as an unidentified musculoskeletal cause.
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Other symptoms have to do with cranial nerves.
- Ear-ringing . Tinnitus can be a nuisance, especially at bedtime when it seems to get louder as youre trying to fall asleep. About 10 percent of people with Lyme experience this (
- Hearing loss. One study reported that 15 percent of Lyme patients experienced loss of hearing .
- Jaw pain or toothaches that are not related to actual tooth decay or infection.
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What Increases Your Risk
The main risk factor for Lyme disease is exposure to ticks that are infected with Lyme disease bacteria. In areas where Lyme disease is widespread, such as the eastern and south-central areas of Canada, southern British Columbia, and northeastern United States, several factors may increase your risk, including:
- Spending time outdoors during the warm months of the year when ticks are most active. This is usually between May and November, with peak activity in June and July.
- Having indoor/outdoor pets. They can bring infected ticks into the house. Although dogs and cats can become infected with the Lyme disease bacteria, they cannot pass the illness to humans. But the infected ticks can drop off the animal and then bite and infect a person.
- Having a stone fence or a bird feeder near your house. Stone fences often become homes for mice, and mice may feed on spilled seed from a bird feeder. Where there are mice, there are ticks.
Remove ticks right away, as soon as you notice them. Your risk for getting Lyme disease increases the longer a tick is attached to your body. Ticks generally cannot transmit Lyme disease until they are attached for at least 36 hours.
Chronic Lyme Disease Patients Profoundly Debilitated
Many patients with chronic Lyme disease are profoundly debilitated. Investigators of the four NIH-sponsored retreatment trials documented that the patients quality of life was consistently worse than that of control populations and equivalent to that of patients with congestive heart failure. Pain levels were similar to those of post-surgical patients, and fatigue was on par with that seen in multiple sclerosis.
An LDo published survey of over 3,000 patients with chronic Lyme disease found that patients suffer a worse quality of life than most other chronic illnesses, including congestive heart failure, diabetes, multiple sclerosis and arthritis. Over 70% of patients with chronic Lyme disease reported fair or poor health. Similar results have been found in other studies. Many of the symptoms associated with Lyme disease are common in other diseases. The CDC surveillance criteria for confirmed cases specifically exclude most of the symptoms that patients report, including fatigue, sleep impairment, joint pain, muscle aches, other pain, depression, cognitive impairment, neuropathy, and headaches. However, these common symptoms can be severe and may seriously affect quality of life.
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What Is Chronic Lyme Disease’
There is no agreed definition of the term chronic Lyme disease among doctors so it can mean different things to different people. Some people use the term chronic Lyme disease to describe a range of non-specific symptoms including chronic tiredness and unexplained neurological symptoms, even when there is no evidence of past or current Lyme disease infection.
The non-specific symptoms overlap with those of several other conditions including fibromyalgia and chronic fatigue syndrome, which can be triggered by common infections such as the glandular fever virus, and more recently COVID-19.
How Common Is Untreated Lyme Disease
Its difficult to get exact numbers when it comes to Lyme disease, in part because theres only limited accounting of the conditions frequency overall, and its often misdiagnosed or mistaken for other conditions.
Currently, its estimated that 476,000 people develop it in the United States every year, with 81% of the cases clustered in the Northeast, upper Midwest, and mid-Atlantic regions.
A significantbut shrinkingproportion of those with the disease end up progressing without treatment. Current estimates are hard to come by. In 2012, researchers estimated that about 16% of Lyme disease cases present without rashincreasing the chance that the case is missed, overall. From 1.6% to 7% of all infections have no symptoms.
Knowledge and awareness of this disease have grown over the past couple of decades, greatly improving outcomes. This improving prognosis is associated with better care and detection, leading to timelier intervention.
If you live in a hot spot area for black-legged ticks, never hesitate to reach out to your healthcare professional if youre feeling sick or have a rash.
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Can You Live With Lyme Disease And Not Know It
One of the only reliable ways to know whether or not you have Lyme disease is through a lab test. This means that if symptoms go unnoticed, it is possible to live with the disease for weeks, months, or even years and not realize it. This is why its crucial to get tested if you suspect you could have contracted Lyme disease.
LetsGetCheckeds at-home Lyme Disease Test can identify Borrelia antibodies in the blood, which can indicate the presence of Lyme disease . Online results will be available within 2-5 days and our dedicated clinical team will be available to help throughout the process to answer any questions you may have.
You should consider taking the test if:
- You are presenting with symptoms of Lyme disease
- You live in a place that is rich in vegetation or a woodland area
- You live in Northern America or Northern Europe
- You go camping or hiking on a regular basis, particularly during the Summer or Autumn
- You come into contact with larger woodland animals on a regular basis
If you develop the erythema migrans rash, or if you experience any neurological symptoms, you should contact your doctor immediately.
What If I Dont Feel Better After Treatment
If youre treated for Lyme disease and dont feel better after youve finished your treatment, talk to your doctor. He or she may recommend a longer course of antibiotics or may be able to prescribe another medication to help with symptoms like joint or muscle pain.
You might also want to seek a second opinion, especially if your Lyme disease diagnosis was not initially confirmed via a two-step blood test. If your body has not responded to antibiotics, its possible that something else besides the bacteria that causes Lyme disease is making you sick. In 2017, for example, the CDC reported on a woman who was given antibiotics and herbal remedies to treat her chronic Lyme disease, when she actually hadand eventually died fromamyotrophic lateral sclerosis .
Even if you do recover completely from a Lyme disease diagnosis, your immune system may continue making antibodies to fight Lyme disease bacteria for months or even years after the infection is gone. Those antibodies wont protect you from getting a second Lyme disease infection, however, so be sure to take steps to protect yourself from ticks in the future.
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Symptoms Of Early Stage Lyme Disease
According to the Centers for Disease Control and Prevention , early-stage Lyme disease symptoms crop up within 3 to 30 days after exposure and can include but are not limited to:
- Joint pain and swelling
- Swelling of the lymph nodes
- Erythema migrans , a bulls-eye-shaped rash that appears at the site of the tick bite
Early Lyme disease does not always appear the same in all patients. For example, up to 30% of patients dont remember experiencing a bulls eye rash.
What Are The Signs Of Lyme Disease
Looking out for symptoms of Lyme disease, and checking yourself for ticks after you go to green spaces where they may be presentis very important. Prompt tick removal can reduce your chances of acquiring Lyme disease.
Rapidly recognising symptoms can ensure that if you are developing the disease you can receive the earliest diagnosis and treatment from your GP. If you are bitten by an infected tick your symptoms will typically develop 1-4 weeks after being bitten, however, they can appear anytime between 3 to30 days after exposure.
Symptoms include a spreading circular red rash, which may appear as a bulls-eye rash like the image below, as well as non-specific flu-like symptoms. Although a lot of people associate the disease with the rash, 1/3 of people dont report seeing one.
Other signs to look out for include muscle or nerve pains or a drooping facial appearance when the nerves to the muscles around the upper part of the face are affected.
If you have developed symptoms after being bitten by a tick or spending time outdoors, immediately contact your GP or call NHS 111, mentioning where you have been and if you remember being bitten.
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What Are The Complications Of Lyme Disease
Lyme disease affects people differently. Relapse and incomplete treatment responses happen. Relapse and incomplete treatment responses happen. Complications of untreated early-stage disease include:
Frequent hospitalizations to manage the disease
Some of these complications result in chronic, debilitating conditions.
Some people may develop post-Lyme disease syndrome . A condition also known as chronic Lyme disease includes PLDS, but also other syndromes. Usually, these are characterized by persistent musculoskeletal and peripheral nerve pain, fatigue, and memory impairment.
How You Get Lyme Disease
If a tick bites an animal carrying the bacteria that cause Lyme disease, the tick can become infected. The tick can then transfer the bacteria to a human by biting them.
Ticks don’t jump or fly. They climb on to your clothes or skin if you brush against something they’re on. They then bite into the skin and start to feed on your blood.
Generally, you’re more likely to become infected if the tick is attached to your skin for more than 24 hours. Ticks are very small and their bites are not painful, so you may not realise you have one attached to your skin.
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Are Some Locations More At Risk Than Others
Yes and no. There are areas in which the bacteria is endemic meaning the disease is established and present more or less continually in that community.
In Canada, blacklegged tick populations have been confirmed or are growing in the following areas:
- Southern British Columbia.
- Southern New Brunswick and Grand Manan Island.
- South shore and northern mainland Nova Scotia.
However, it is important to note that ticks can be spread by birds, in particular songbirds that feed off the forest floor. Because these birds are migratory, there is the potential for new populations of the bacteria to spread across the country. This fact means that you do not have to be in an endemic or high-risk area to be at risk of contacting ticks and the disease.
Lyme Disease In Missouri
The first question to ask is, Does Lyme disease occur in Missouri? There have been patients with symptoms similar to those in other areas of the United States, but B. burgdorferi has not yet been isolated from any patients in Missouri. Lyme disease is nationally notifiable and is therefore notifiable in Missouri. Missouri patients who fulfill the strict CDC case definition for Lyme disease are reported as such. Because the EM rashes of Missouri origin are similar to those in other parts of the country, they are referred to as EM-like by the Division of Vector-Borne Infectious Diseases, National Center for Infectious Diseases, CDC. The clinical syndrome associated with the EM-like rash appears similar to Lyme disease and is called Lyme-like disease.
The uncertainty regarding the occurrence of Lyme disease is not unique to Missouri . Determining the geographic distribution and prevalence of a disease-causing agent is always challenging, particularly when the agent is a relatively recently identified one. This problem is compounded many fold, when one realizes that it is not only the distribution and prevalence of the agent that must be considered, but also that of possible reservoirs and vectors that maintain and transmit the agent. All of these factors must come together at the same place and time before disease can be caused in a host.
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What Might A Doctor Misdiagnose Lyme Disease As
Ticks can carry a variety of different organisms and diseases with them.
The lone star tick can carry a disease known as southern tick-associated rash illness. The rash it causes to a Lyme disease rash. In addition, it can cause similar symptoms to Lyme disease, including fever, fatigue, joint and muscle aches, and headache.
Symptoms Of Late Stage Lyme Disease
The CDC reports that late stage Lyme disease may appear days to months after the initial tick bite and may include but are not limited to:
- Severe headaches and neck stiffness
- Additional EM rashes in new places on the body
- Facial palsy, also known as Bells palsy paralysis of one side of the face
- Arthritis or joint pain and swelling, especially of large joints
- Intermittent tendon, muscle, joint, nerve, or bone pain
- Heart palpitations or arrhythmia
- Dizziness or shortness of breath
- Inflammation of the brain or spinal cord
- Shooting pains, numbness, or tingling in the hands or feet
As mentioned above, late stage Lyme may also be characterized by the recurrence of early stage symptoms, such as fatigue.
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Can Lyme Disease Be Treated
In most cases, yes. Antibiotics can effectively treat Lyme disease, especially when treatment begins early. Cases that reach the later stages of the disease, however, can be difficult to treat and some symptoms can persist.
PHAC reports that removing the tick within 24-36 hours usually prevents infection.
Early Detection Is Key
Lyme disease is easiest to treat at the early or acute stage, within the first 30 days of exposure. This is why its so important to take precautions to prevent tick bites, both during and outside of tick season. Protect yourself when near potential tick habitats, always perform tick checks after outdoor activity , and dont delay seeking medical attention if you notice any symptoms that might be related to tick-borne illness. Its important to get tested as soon as possible for the best chances of recovery.
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What Are The Signs And Symptoms Of Lyme Disease
Early signs and symptoms of Lyme disease usually start three days to one month after being bitten by an infected tick. Although symptoms of Lyme disease can be different from person to person, most people experience mild flu-like symptoms soon after being bitten. A small number may have more serious symptoms, sometimes weeks after the bite.
Early signs and symptoms of Lyme disease may include:
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Chronic Lyme Disease Vs Ptlds
The terms chronic Lyme disease and Post-Treatment Lyme Disease Syndrome are sometimes used interchangeably. However, PTLDS is slightly more restrictive, referring to patients who have received treatment for Lyme disease but go on to experience Lyme disease symptoms. It does not include those who received a misdiagnosis or delayed diagnosis and have developed chronic symptoms of Lyme disease before receiving any kind of treatment.
The CDC defines PTLDS as generalized and/or recurring pain, fatigue, and cognitive difficulties that last for more than 6 months after treatment. These mirror symptoms associated with chronic Lyme disease, with or without treatment.
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The Numbers On Chronic Lyme
Because Lyme disease is commonly missed or misdiagnosed, statistics vary on how many Lyme patients go on to experience chronic symptoms. The following research nonetheless paints a basic picture of the problem.
- An estimated 5-20% of patients may have chronic symptoms after getting Lyme disease, according to the Columbia University Irving Medical Center.
- The treatment failure rate for chronic Lyme disease patients was estimated at 26-50% in 2004, compared to 16-39% for early Lyme patients, according to Lymedisease.org.
- Up to 15-40% of late-stage Lyme patients develop neurological disorders, which are responsible for many common symptoms of chronic Lyme disease.
Experts dont know for sure why some people experience persistent symptoms, even with treatment. However, some believe the Lyme infection may trigger an auto-immune response that manifests in the chronic symptoms detailed below.