Small tick, complex disease

By Anne Sophie Le Brun Robles Gil

Last year, Quebec recorded 500 cases of Lyme disease. This number has been steadily increasing since 2014 and will likely continue to increase. Whiles 500 cases does not seem like a lot at first glance, Lyme disease can be difficult to diagnose. But with the right information, it is fairly easy to protect yourself from it.
So, what is Lyme disease? Lyme disease is caused mostly by Borrelia burgdorferi, a bacterium that can be transmitted to humans through a tick bite. Although there are about a dozen species of ticks in Quebec, only the blacklegged tick (Ixodes scapularis) is of any real medical concern at the moment.
Not all blacklegged ticks are infected with the pathogen that causes Lyme disease. Ticks have three life stages (larva, nymph, and adult) and in most species, these only feed once per life stage, explains Dr. Jade Savage, professor of entomology at Bishop’s University and principal investigator of eTick, a tick monitoring program. They can only get or give Lyme disease by feeding, so the only way a tick is infected is if it has previously bitten, say, an infected rodent.
In humans, Lyme disease is best known for causing a bull’s eye rash and flu-like symptoms, but that is just the tip of the iceberg. Lyme disease can cause a variety of arthritic (pain-, inflammation-, and joint-related), neurological (nerve- and brain-related), and cardiac (heart-related) symptoms. These often make Lyme disease look like other diseases, which may in turn complicate or delay diagnosis. Even the bull’s eye rash does not develop on everyone and is less likely to be visible if you have darker skin.
Testing for it is not any easier. Tests that look for antibodies to Lyme disease must be carried out at least 4-6 weeks after getting infected (so the immune system has the time to develop a detectable response) and the interpretation of the results is complex.
So, what can you do to avoid getting Lyme disease?
The first thing is to avoid getting bitten by a tick. The easiest way to do this is by wearing socks and pants when walking in tick habitat, preferably with the pants tucked into the sock. You can also get tick repellent.
It is always possible a tick still manages to bite you. That is why tick checks are important. Tick checks are full-body checks you can do on yourself, your kids, or even your dog if you think you may have been somewhere where there might be ticks. This could just be your backyard; ticks tend to like areas where there are tall grasses and small bushes. When you do the tick check, make sure you check your scalp and any nooks where the tick could hide (including the more intimate ones).
If you do find a tick, the next step is to remove it. You can find detailed instructions on how to remove a tick properly online, including on eTick.ca. Remember that, in Quebec, only blacklegged ticks can give you Lyme disease. To find out if the tick you just removed is a blacklegged tick or not, you can once again use the eTick.ca website or the eTick mobile application. You will be able to submit a photo of your tick and they will let you know the species.
Let’s say it does turn out to be a blacklegged tick. Ticks are slow feeders that will take several days to complete a blood meal. While the probability of getting infected with B. burgdorferi remain low if the tick has been attached less than 24 hours, it might still be a good idea to consult your local pharmacy. Many pharmacists in the province can provide a single dose of antibiotics (also called post-exposure prophylaxis) that, if administered within 72 hours of tick removal, should kill any B. burgdorferi that might have been transmitted in tick saliva.
Whether or not you get post-exposure prophylaxis, you should still monitor yourself for early Lyme disease symptoms for some 30 days after having been bitten by a blacklegged tick. If you start having any symptoms or have any concerns, contact your doctor and let them know you were bitten by a blacklegged tick.
Your vet will also be able to provide you with preventative treatments for your dog.
There is a lot in the way of Lyme disease prevention, so do not let ticks keep you from going out and enjoying our wild spaces. Just make sure to take a few steps to stay safe.

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