LYME DISEASE IN QUEBEC – A TICKING TIMEBOMB?
For The Gazette by Robert J. Galbraith
Montreal-Quebec’s leading authority in the science of tick biology says that the southern part of Quebec has become ground zero in the spread of the debilitating disease commonly known as Lyme’s disease, and that little is being done by the provincial or federal health officials to notify the public and physicians of this very real and increasing health threat.
“We could have a real problem on our hands if things keep going the way they are,” explained Dr. Alain Villeneuve, a Professor of Parasitology at the Faculty of Veterinary Medicine of the Université de Montréal, in St-Hyacinthe. “The public should be made more aware of the reality of Lyme disease (LD) and its spread and know how to take precautions to prevent infection.”
Meanwhile, Lyme’s disease (LD) cases are skyrocketing along the Vermont, New York and Maine borders with Quebec, where as of last year, close to 20,000 cases of LD infection were reported in humans. Ontario reported 102 cases in 2008 (though this number may actually be much greater due to misdiagnosis of the symptoms and infection) and the numbers of infection are growing as the infected tick numbers spread through this neighbouring province.
LD is a bacterial infection caused by the bite of the black-legged tick (also referred to as the deer tick). If untreated, it can cause serious health symptoms that affect many systems of the body, but it can be effectively treated if caught in the early stages of infection. The longer the disease remains undetected, the more serious and debilitating the symptoms become and the more difficult they can be to treat.
A second tick, more common to Quebec, is the brown or dog tick. Unlike the deer tick, this tick does not carry the Lyme bacteria, though its bite can cause a number of different sicknesses.
As the deer populations in Quebec increase, so does the tick population. Climate change is also a contributing factor to the spread of ticks. The warmer our winters become, means the more ticks that will survive to cause problems.
Dr. François Milord, a medical consultant with the Institut national de santé publique du Québec, agrees that more must be done to reach the medical workers and the public living in Quebec, particularly in the Montérégie and southern regions of the province. “If we look at what has happened in other areas, the numbers will probably increase in coming years. This is the time to inform all parties about this potential growing problem.”
He explained that, “last year we sent some information (a brochure) to all physicians in private clinics and CLSC’s, by mail, on various subjects including LD. We may need to do more, but at this time, we have done nothing to notify the public, though there is information on LD on the Ministère de la Santé (INSPQ) web site.
When Milord was asked if there was a chance that the brochure sent to the medical workers might have been put aside, not read, or discarded as junk mail, he responded. “It’s true they (medical workers) receive a lot of information on many different subjects and many may have not seen the article on LD because they chose not to look at this specific brochure.” Milord explained that, “we have been working with Health Canada in collaboration of our field studies. The ticks found on humans and animals are sent to the Health Canada office in Winnipeg for analysis. Humans showing symptoms of LD are studied here.”
He explained hat the first reported case of LD in Quebec was in 2004. “What I know is that from 2004 to 2007, cases that were reported in the province were all instances of LD that were acquired outside of Quebec, in the United States, (LD is also widespread in Europe and Asia).
It was in 2008 that the first confirmed case was acquired inside Quebec, in the Montérégie. “If we look at what has. From 2004 till 2009 we have had between 8-15 cases per year, with most of these cases caught outside the province. We had 13 cases in 2008. Of these, 10 were caught outside the province and 3 in the province. In 2009 there were 14 cases, and of these, 4 were acquired in Quebec.”
The same concern about the spread of LD in Quebec is being voiced by Jim Wilson, the president of the Canadian Lyme Disease Foundation (CanLyme), formed in 2004. He holds no punches when strongly emphasized; “the situation in Quebec is ridiculous! Research in Quebec has been very limited and very much under reported. Rather than be pro-active, they (health officials) swept it under the carpet and hoped it would all go away,” he stated. “In the next five years LD will rear its ugly head and be a huge problem in that province. Then the authorities will be forced to acknowledge they should have taken this threat seriously twenty-years ago, when the writing was on the wall.”
Wilson says it is appalling and the public should be angry and demanding answers from the government. They should be doing much more investigation, not in the field, but on human pathology. We already know it (the deer tick) is here and widespread. “Its time to start doing human research and stop doing it on ticks”
Wilson himself was an LD victim. He contracted it after being bit by a tick in 1991, in Dartmouth NS, where he lived at the time. Shortly after being bit, he noticed a bull’s-eye-type rash around his navel, but the local doctors didn’t know what it was. Shortly after it appeared, the rash went a way. Months later he became very sick. “At this time we moved to British Columbia where I visited a whole series of doctors, going from specialist to specialist,” he explained. “But it was misdiagnosed, the physicians were unable to find what was going on.”
At this time he found a book on LD and mentioned the possibility of himself having LD, but the doctors were sceptical. “It was finally a doctor in BC that confirmed it was LD, in 1994. Once the treatment kicked in, it was absolutely amazing. I didn’t feel like I wasn’t dying anymore.”
He says present testing is completely inadequate and using 1980’s technology. They should be running multiple tests.”
Deer ticks in all stages of reproduction are now well established in the province, whereas studies initiated in 2004 indicated that only adult deer ticks were being found in Quebec. “They were probably the result of adult ticks attaching themselves to migratory birds in contaminated regions of the United States. Then when the birds migrate to Quebec, the ticks would drop off looking for a host to feed on their blood,” he said.
Then in 2007, during field work, Milord and his associates found that the full tick breeding cycle (larva, nymph and adult) in Quebec had become a reality and, “they seemed to be well adapted and growing in numbers.” He also acknowledged that Lyme carrying ticks, “are widespread in the province because of the ticks hitchhicking on migratory birds.” He admits research could have started a few years earlier but it began in 2007.
Lyme disease was first identified in Lyme, Connecticut in 1975. They didn’t understand what it was until 1982. It was believed to have come into the US from Europe or Asia on someone’s pet and spread from there.
The disease is difficult to diagnose as its symptoms are not consistent. It has been often called the ‘great imitator’ by medical researchers and physicians as it is very illusive and can impersonate a number of different diseases and neurological disorders at the same time. It can be first recognized as a rash near the bite area, but even the rash is not present in all cases. It can affect the brain, joints, the lungs, central nervous system; every organ of the body. Each case can be different and the great majority of cases in Canada are misdiagnosed due to a lack of knowledge of the symptoms by physicians. “We don’t know how many are suffering because of misdiagnosis,” says Wilson.
“Advanced stages of Lyme’s are very similar to the symptoms of Multiple Sclerosis. But because of the ignorance in the medical field, Lyme sufferers can be misdiagnosed as suffering from something else, such as multiple sclerosis, Alzheimer’s disease, chronic fatigue, ALS, Crohn’s disease, Parkinson’s, advanced arthritis, respiratory and a variety of psychiatric and psychological disorders,” he explained.
“We should be giving those sufferers of MS symptoms the LD antibiotics, and if they don’t improve, then they actually have MS, but if they do improve, then we know it was Lyme’s. We really have to catch up to speed on the analysis as so many can be misdiagnosed and be suffering unnecessarily.”
He states that it is a misconception that deer ticks only live on deer. They are just as likely to live on shrews, white footed mice, squirrels, as well as our pets. If your dog sleeps on your bed, you’d better damn well make sure it doesn’t have ticks, otherwise they may end up feeding off you.”
Wilson recommends that pet owners use latex gloves to examine their pets for ticks, paying close attention to the ears, around the face, eyes, legs and belly, looking for unusual lumps. Ticks will range in size from the size of a poppy seed to the size of a fingernail (when it has drawn blood and ready to drop off).
When a tick is found embedded in the skin, use fine pointed tweezers at the point of attachment, and grasp firmly. Using slow, steady, pressure, pull the tick straight out from the skin, and then cleanse the skin with mild soap and water. Do not twist or jerk the tick. Place the tick in a jar of alcohol or a jar with a dampened cotton swab, so it doesn’t dry out and contact Santé Quebec or Health Canada as to where to send the tick for analysis. Do not grasp and squeeze the tick’s body as it will regurgitate its body juices into the human body. Also, do not coat the tick in Vaseline, or alcohol or burn it off with a hot match as this will aggravate the tick and it may release more bacteria into the bloodstream. The only safe way to remove them is what is described above. You can also bring your pet to the vets and have them remove it.
Ticks prefer to live in or near wood piles, wooded and bushy areas with high grass where it is moist and cool. When visiting areas where ticks are known to inhabit, wear light coloured clothing so you can see any tricks on your clothing and wear long pants and shirts and tuck your pants into your socks. You can also apply the insect repellent DEET on skin and clothing but not on skin under clothing. DEET dissuades ticks from attaching to you. When you come home (or while still outside is recommended), check yourself, your pet, or your children all over for ticks, especially anywhere hair grows on the body.
Wilson explained that the message that, “no tick is a good tick, must get out to the public. These organisms are very, very dangerous and its not just deer ticks but other diseases passed on by all ticks. And why is there no massive education going on where these creatures are known to occur. There should be bilingual poster campaigns advising the public what to watch out for and how to safely remove ticks from themselves and their pets. There should also be TV ads and most importantly, physician awareness.”
Websites of interest; www.canlyme.org, http://www.phac-aspc.gc.ca/id-mi/lyme-eng.php , http://www.inspq.qc.ca/english/default.asp?A=7