Lyme disease is a bacterial infection caused by the bacterium Borrelia burgdorferi. It is transmitted to humans by a bite from an infected tick. To date deer ticks (Ixodius scapulars) appear to be the main ticks responsible for causing Lyme disease. The symptoms of Lyme disease often involve multi systems in the body causing varying symptoms. This has lead to the disease often being called “The Great Imitator” as it mimics many other diseases. Common complications and organ involvement may include the following; the heart, brain, joints and the central nervous system. If diagnosis and treatment is not pursued in a timely manner this infection could potentially lead to complex and chronic health concerns. Please visit our “Testing and diagnosis page” for further information on signs and symptoms of Lyme disease and samples of Lyme disease related rashes.
A study published in 2012 estimates that by 2020, 80% of Canada will have established tick populations which in turn will increase the potential exposure and spread of Lyme disease. In Ontario multiple areas have been designated ‘endemic areas’ where the risks of infection are considered high. The Public Health Agency of Canada consider the following regions endemic: Point Pelee National Park, Rondeau Provincial Park, Turkey Point Provincial Park, Long Point peninsula including Long Point Provincial Park, Pinery Provincial Park and the National Wildlife area, Windsor, Niagara Falls, Wainfleet bog, the City of Hamilton, Mississauga, Pickering, Prince Edward Point and Parts of the Thousand Islands National Park, Kingston, Orillia, Brockville, Westport, Smith Falls, Ottawa, Cornwall, Kenora, Rainy River and Thunder Bay (PHAC 2019). It should be strongly emphasized that regions that are not considered endemic do NOT mean that they are ‘Lyme disease free or safe” and ticks with possible Borrelia infection are found throughout the province. Please also consider and note regions outside of Ontario when travelling as there has been multiple locations in Canada, the US and Europe that are deemed high risk.
The CDC estimates that over 300,000 people are infected every year in the United States. That is six times the number of people diagnosed with HIV/AIDS and almost double the number of women diagnosed with breast cancer yearly.
Tick bite prevention is vital to reducing the number of cases of this global emerging disease/concern. Please take the time to read and practice the following guidelines to keep yourself, friends and family safe from Lyme disease.
- When exploring areas where you are at an increased risk of potential tick exposure (forested areas, long grass, hiking etc) wear long pants, shoes with socks and long-sleeved shirts. Wearing light coloured clothing will make it easier to spot ticks. You should always tuck your pants into your socks. Always walk in the middle on any pathways or trails and avoid low-lying brush or long grass.
- Apply insect repellent to your skin and clothing, especially at the openings such as ankle, wrist and neck. Repellents with Picaridin/Incaridin have been shown to work.
- Perform a “Tick Checks” daily: – this is the most important and effective prevention strategy!
Ticks thrive in warm moist environments. It is important to check between the toes, behind the knees, private areas, armpits, belly button, in the ears, nape of the neck, and in the hair.
When you come in from outdoors remove clothing and place , all clothes in the dryer on high heat for at least 10 minutes. Studies have shown ticks can survive being submerged in water for 2-3 days.
Symptoms of Lyme Disease
Lyme disease treatment is more effective in the early stages of infection. If diagnosis and treatment is not pursued in a timely manner this infection could potentially lead to complex and chronic health concerns. Acute symptoms of Lyme disease include but may not be inclusive to all are:
- stiff neck
- muscle ache
- joint pain
- GI issues
However, it has been well established that the varying clinical manifestations of Lyme disease and possible related infections have made diagnosis difficult therefore leading to delay in treatment. It is important to document symptoms, timing frame of illness and possible exposure risk when discussing Lyme disease with your health care practitioner. The Horowitz Questions is a helpful tool that can be taken and reviewed by your health care practitioner:
Late Stage Lyme disease symptoms include but may not be inclusive to all are:
- memory Loss
- mood swings
- ringing in the ears
- heart palpitations
- night sweats
- white matter leisons (MRI)
- bell’s palsy
- difficulty thinking
- blurry vision
- joint pain
- poor balance
- gastrointestinal problems
The Horowitz Questionnaire is a helpful tool that can be taken and reviewed by your health care practitioner:
Testing & Diagnosis
Serological testing for Lyme disease is riddled with conflicting literature on accuracy, sensitivity and use. Therefore it is strongly advised that diagnosis is based on clinical presentation and risk factors. Serological testing is supportive of a diagnosis however patients should be aware of limitations to the available blood tests. In Ontario Lyme disease testing follows a two-tiered process which measures antibodies in the blood. The first step is called enzyme-linked immunosorbest assay (ELISA) and the second step are western blots. If the ELISA (the first step) is negative, then the western blots (second step) will not be performed. It has been noted that this two -teired testing process has limitations due to false negative results. Therefore it is very important that clinicians assess each case and not rule out this disease based on serology alone.
Private laboratory testing for Lyme and other vector borne are available. Below are the well-established laboratories that accept Canadian blood samples;
You not require a Physician’s signature on the blood requisition. All test results will be emailed to you directly.
Armin Lab test kits are available with shipping materials at no charge directly from:
Email for a free kit: firstname.lastname@example.org
IGeneX test kits are available with shipping materials at no charge directly from IGenex, Inc
Email for a free kit: email@example.com
In 2014, the US Department of Health and Human Services (HHS) ruled that patients are entitled to have direct access to their lab test reports without having them sent to a physician first. Patients can call the IGeneX 1-800 number above, and request that their laboratory results be mailed directly to their home address.
Treatment of Lyme disease is highly contentious in the medical community. There is conflicting literature on how to treat Lyme disease and 2 distinct guidelines exist:
International Lyme and Associated Diseases Society (ILADS) guidelines
Infectious Diseases Society of America (IDSA) guidelines
It is recommended that patients seek medical advice and treatment from a clinician with experience and knowledge of this disease. Physicians such as medical doctors (MD) or Naturopathic doctors (ND) who are knowledgeable with this disease are commonly known as ‘Lyme-literate’. Please contact us for more information on local practitioners.