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Lyme Disease: Presentation to TDSB Health and Well-being Committee

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Howard Shapiro

Associate Medical Officer of Health & Director Healthy Environments

hshapir@toronto.ca

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May 31, 2016

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Overview

  • Lyme Disease

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  • Tick Vector

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  • Lyme Disease Statistics

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  • Toronto Public Health Program

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  • Final Thoughts

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What is Lyme Disease

  • Caused by infection with a bacteria
      • Borrelia burgdorferi
  • Transmitted by a particular species of ticks in Ontario
      • Blacklegged ticks (Ixodes scapularis)
  • Important implications
      • Not spread person to person
      • Can prevent by preventing tick bites
      • Treatable with antibiotics – especially early in disease

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Lyme Disease – Early (days-weeks)

    • Symptoms
      • Headache, tiredness, muscle and joint aches and pains, fever (sometimes)
      • Red rash at site of bite (Erythma migrans)

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    • Treatment
      • Oral antibiotics for 2-3 weeks
      • High effective

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Lyme Disease – Late (weeks-years)

    • Symptoms
      • Joints - arthritis (knee and other large joints very common)
      • Heart – palpitations or irregular beat
      • Nervous system – drooping face, inflammation of brain and spinal cord, pains/numbness/tingling in hands and feet; fatigue/difficulty thinking
    • Treatment
      • Antibiotics – oral or IV for 2 weeks to 1 month
      • Less effective than for early
      • Symptoms may persist despite treatment
        • more likely the longer the time until treatment

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BL Tick Habitat

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Blacklegged tick Life stages and size

R. Lindsay PHAC

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How big is that tick?

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Tick Attachment

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Ixodes Tick Life Cycle

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Questing tick

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Risk of Lyme Disease Increases with Time Tick Attached

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Opportunity for Prevention

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Human Lyme Disease in Toronto: Cases & Incidence Rate 2004-2014

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Ontario Lyme Cases by Month - 2013

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Toronto Public Health Lyme Program

  • Surveillance (monitoring)
      • Human
      • Tick (tick populations in Toronto)
        • Passive people bring in ticks for submission to Lab
          • Identified and tested for Lyme bacteria
        • Active
          • Go to likely locations and search for ticks (ID & testing)
  • Education
      • Information for public and physicians through a number of means
      • Fact sheet for schools

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Tick Dragging

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Final Thoughts

  • Risk of Lyme disease in Toronto possible but very low (but may be changing)
  • Child with Lyme disease cannot give it to someone else
  • Child with attached tick should have removed promptly (parent, physician)

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Final Thoughts

  • Be aware of tick locations & habitats in and outside of City especially for outdoor activities
  • Typical school yard -lawns, sport fields not tick habitat
  • Can prevent ticks and Lyme
      • Staying in centre of trails
      • Clothing and DEET
      • Tick checks, tick removal and showering after being in tick habitat

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���HSHAPIR@TORONTO.CA

Questions??