The following information is only as accurate as the last update! However, it is a starting point.
All sources indicate that the number of disease carrying ticks in Canada continues to climb. There are many known endemic areas throughout the country but black-legged ticks (formerly known as deer ticks) can now be found just about everywhere. Therefore, everyone should be aware of what to look out for and how to remove a tick if they find one. Ticks are no longer just in the woods. They can be found in manicured parks, golf courses, backyards, etc. Please make yourself knowledgeable!
Remember, as well, that ticks can be active all year depending upon the weather. Although they are most active in the spring and fall, they can even be around in the winter if temperatures go above 4C (and sometimes even lower!).
Although freeze/thaws during the winter can kill off some ticks, a consistent snow cover is good for them. They can “hibernate” and come out hungry as soon as temperatures allow.
Also important to note is that ticks can carry other diseases along with, or instead of, Lyme disease. Other diseases can include Human Granulocytic Anaplasmosis, Powassan Virus, Babesiosis, Ehrliciosis, Bartonella, Borrelia miyamoto, Rickettsia, and Tularemia, to name just a few. New tick borne diseases are frequently being discovered. Prevention is key as it is very hard to determine all that a tick is carrying!
Last, but certainly not least, the amount of time a tick has to be attached to transmit disease is really unknown at this time. There is a recent research article regarding this issue – “Lyme borreliosis: a review of data on transmission time after tick attachment” – http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4278789/. The sooner you get an attached tick off of you the better! Powassan virus can be transmitted in 15 MINUTES. Daily tick checks should be routine.
Before You Go Outdoors
– Know where to expect ticks. Although they can be anywhere due to migratory birds, deer, rodents, etc., ticks tend to prefer moist and humid environments, particularly in or near wooded or grassy areas and near water. You may come into contact with ticks during outdoor activities around your home, such as around wood piles or in gardens, raking, or when walking through leaf litter or near shrubs. Always walk in the center of trails in order to avoid contact with ticks.
– Consider wearing a repellent but be aware that many repellents just keep the ticks away from the areas that are covered. Ticks may walk around until they find an area of skin without repellent. According to a June 13, 2014, Canadian Paediatric Society Document, “Icaridin is considered to be the repellent of first choice by the Public Health Agency of Canada’s Canadian Advisory Committee on Tropical Medicine and Travel for travelers six months to 12 years of age. Products containing up to 20% icaridin are considered to be safe and efficacious”. Consumer Reports has also recently done a review of bug repellents and recommends Sawyer Premium Insect Repellent 20% Picaridin. There is a product available in the US called Permethrin that actually kills ticks. Products with some permethrin can be purchased in Canada. it is for use on clothing, equipment, etc., rather than on your skin. It is widely used by the US and Canadian Military on their uniforms, as well as many in the US that work or spend a lot of time outdoors. A small variety of “No Fly Zone” Clothing is now available in Canada via Mark’s. Unfortunately, for some reason, it cannot be advertised as being tick repellant clothing, although I believe it is the same product that is sold in the US as such.
– There are also natural products that can be used to repel ticks. Most of the natural products require frequent reapplication. However, there is a new product that is presently going through testing and approval that is made right here in Nova Scotia. Atlantick is slowly going through the process for approval to advertise as a tick repellent – https://www.halifaxtoday.ca/local-news/mahone-bay-woman-applies-for-health-canada-approval-for-her-tick-spray-925221. In the meantime, you can still purchase it in a variety of places. Arm yourself with information!
– If at all possible, wear light colored clothes, with a tight weave, so that you can spot the ticks more easily and tuck your pants into your socks and shirt into your pants so you have more time to find the ticks on your clothes before they get to your body. However, this is generally not realistic for the warmer months.
– Two-sided sticky tape or a lint roller works at picking unattached ticks off your clothes or body. The tape could also be used to trap them as they are traveling upwards by wrapping it around your socks, boots or pants.
– Have a tick kit (or more than one) that includes a tick removal device (either fine-tipped tweezers or a tick removal tool that grasps the tick as close to the skin as possible without squeezing the body or twisting); antiseptic, a magnifying glass (they are small), small plastic bags/containers, bandaids, pencil, paper, scotch tape (this info is explained in more detail here – https://www.littlethings.com/diy-tick-kit/. CanLyme also has a tick kit with some of these items included – https://canlyme.com/product/tick-removal-kit/.
Before You Come Indoors
Check your clothing for ticks. Brush yourself down, including your hair, prior to entering the house to prevent ticks from being carried into the house on clothing.
After You Come Indoors
Placing clothes into a dryer on high heat for 15-20 minutes should effectively kill any missed ticks.
Shower/bathe soon after being outdoors. Showering within two hours of coming indoors has been shown to reduce your risk of getting Lyme disease as it may help wash off unattached ticks and it is also a good opportunity to do a tick check.
Check your entire body for ticks after being outdoors. Conduct a full body check upon return from potentially tick-infested areas, which even includes your back yard. Use a hand-held or full-length mirror to view all parts of your body. In particular, check these parts of your body and your child’s body for ticks as ticks prefer warm, moist locations:
- Under the arms
- In and around the ears
- Inside belly button
- Back of the knees
- In and around the hair
- In the groin area
- Around the waist
- Under any bands, such as a bra, etc.
What to Do if You Find an Attached Tick
If you find a tick attached to your skin, or on your pet, there’s no need to panic. There are several tick removal devices on the market, but a set of fine-tipped tweezers will remove a tick quite effectively. You can also remove a tick with string (including dental floss) if nothing else is available. There are good videos on YouTube for all of these methods.
- Use fine-tipped tweezers (or a tick tool) to grasp the tick as close to the skin’s surface as possible. Do not squeeze the body.
- Pull upward with steady, even pressure. Don’t twist or jerk the tick; this can cause the mouth-parts to break off and remain in the skin. If this happens, remove the mouth-parts with tweezers. If you are unable to remove the mouth easily consider having your Doctor remove it for you.
- Never use your fingers as you will end up squeezing the tick which can result in the transmission of disease.
- After removing the tick, thoroughly clean the bite area and your hands with rubbing alcohol, an iodine scrub, or soap and water.
Avoid folklore remedies such as “painting” the tick with nail polish or petroleum jelly, or using heat to make the tick detach from the skin. Your goal is to remove the tick as quickly as possible – not waiting for it to detach. You also don’t want it to regurgitate!
If the tick was engorged and you don’t know how long it was attached for, I would highly recommend trying to get some antibiotics – just in case – as the longer the spirochetes are in your body, the more damage they can do! Sending the tick for testing is very beneficial as many different things can be transmitted. However, the ticks are not always tested for everything.
There are generally two types of ticks that bite in this area, the black-legged or deer tick and the wood or dog tick. Both can carry disease. If you are not sure what type of tick it is you can send a photo to Andrew Hebda at the Museum of Natural History in Halifax, Nova Scotia – firstname.lastname@example.org.
Mount Allison University is accepting ticks from a variety of areas for testing. As mentioned, the type of testing differs from place to place. You can send your ticks to https://www.mta.ca/Community/Research_and_creative/Tick_and_Lyme_disease_research/Tick___Lyme_disease_research/. For other areas, the ticks can be sent to Manitoba – https://www.canada.ca/en/public-health/services/diseases/lyme-disease/removing-submitting-ticks-testing.html.
There are also other places that accept ticks for testing. Some just test for one thing. Some charge higher costs. You may have to check around a bit. These are two that I am aware of:
- Geneticks – A private tick testing lab opened by a former Lyme sufferer – https://www.geneticks.ca/about-geneticks/
- TickCheck – https://www.tickcheck.com/
If you would prefer not to go the antibiotic route, watch for signs of illness such as rash, fever, stiff neck, and/or other flu-like symptoms in the days and weeks following the bite, and see a health care provider if any of these develop. You may have none or all of the symptoms, or more, depending upon your immune system and other factors, such as what co-infections the tick was carrying. Your risk of acquiring a tick-borne illness depends on many things, including where you live, what type of tick bit you, and how long the tick was attached. If you become ill after a tick bite, see a health care provider.
Some people can apparently be asymptomatic, with symptoms not occurring until your immune system is compromised. If you suddenly start to have a variety of symptoms that can affect multiple systems, that come and go and generally are not confirmed by testing, then consider the possibility that you were bitten by a tick.
Reduce Ticks in Your Yard
- Modify your landscape. Regularly remove leaf litter and clear tall grasses and brush around homes, and place wood chips or gravel between lawns and wooded areas to keep ticks away from recreational areas, and keep play areas and playground equipment away from shrubs, bushes, and other vegetation.
- Discourage deer. Removing plants that attract deer and constructing physical barriers may help discourage deer from entering your yard and bringing ticks with them.
- Plant vegetation that repels ticks. There are several good sites. This is just one of many. – http://www.onegreenplanet.org/animalsandnature/plants-to-grow-that-repel-ticks-and-fleas/
- Ticks can be found under groundcovers and Japanese Barberry plants. There is considerable information pertaining to Japanese Barberry plants and a higher incidence of black-legged ticks. Consider bushes that are elevated from the ground so that you can rake underneath or place wood chips or gravel – https://entomologytoday.org/2017/10/04/the-5-year-plan-manage-japanese-barberry-to-keep-tick-levels-low-reduce-lyme-risk/?_scpsug=crawled_129977_c9b57e70-a91d-11e7-a302-90b11c40440d#_scpsug=crawled_129977_c9b57e70-a91d-11e7-a302-90b11c40440d.
- Do not have bird feeders close to the house. Birds can carry ticks and they can drop off anywhere. If you must feed the birds, have feeders away from your house and put wood chips or gravel around the base.
Prevent Ticks on Animals
Use tick control products to prevent family pets from bringing ticks into the home. Consult your Veterinarian and be sure to use these products according to the package instructions
LYME DISEASE: (The following information was taken from the Murakami Centre for Lyme website – www.murakamicentreforlyme.org)
Lyme disease is a complex and rarely understood disease that is systemic in nature. It can present itself with a myriad of symptoms (sometimes well over 100) that can easily lead to misdiagnosis by the untrained professional. We’ve tried to break down the information about this disease to make it easier to understand its complexities.
What is Lyme?
Lyme Disease is an infectious disease carried by various birds, rodents, deer and ticks. There is indication that mosquitos and other biting insects may also be vectors to this disease. It is passed among the animals and insects in this group when a tick latches onto an infected host, usually a Deer Mouse.
The spirochetes (Borrelia burgdorferi) in the infected blood of the mouse enter the blood of the tick and begin another life cycle, or continue their lifecycle in the stomach of the tick. The tick then bites or latches onto a different host and infects the new host with the Lyme disease.
Possible Symptoms of Lyme Disease
(20 or more yes answers represent a serious potential and Lyme and other tick borne diseases should be considered)
The Tick Bite (fewer than 50% recall a tick bite or get/see the rash)
- Rash at site of bite
- Rashes on other parts of your body
- Rash basically circular and spreading out (or generalized)
- Raised rash, disappearing and recurring
Head, Face, Neck
- Unexplained hair loss
- Headache, mild or severe,
- Pressure in Head,
- White Matter Lesions in Head (MRI)
- Twitching of facial or other muscles
- Facial paralysis (Bell’s Palsy)
- Tingling of nose, (tip of) tongue, cheek or facial flushing
- Stiff or painful neck
- Jaw pain or stiffness
- Dental problems (unexplained)
- Sore throat, clearing throat a lot, phlegm ( flem ), hoarseness, runny nose
- Eyes/Vision Double or blurry vision Increased floating spots
- Pain in eyes, or swelling around eyes
- Oversensitivity to light
- Flashing lights/Peripheral waves/phantom images in corner of eyes
- Decreased hearing in one or both ears, plugged ears
- Buzzing in ears
- Pain in ears, oversensitivity to sounds
- Ringing in one or both ears
Digestive and Excretory Systems
- Irritable bladder (trouble starting, stopping) or Interstitial cystitis
- Upset stomach (nausea or pain) or GERD (gastro esophageal reflux disease)
- Bone pain, joint pain or swelling, carpal tunnel syndrome
- Stiffness of joints, back, neck, tennis elbow
- Muscle pain or cramps, (Fibromyalgia)
Respiratory and Circulatory Systems
- Shortness of breath, can’t get full/satisfying breath, cough
- Chest pain or rib soreness
- Night sweats or unexplained chills
- Heart palpitations or extra beats
- Heart blockage
- Tremors or unexplained shaking
- Burning or stabbing sensations in the body
- Chronic Fatigue Syndrome,
- Weakness, peripheral neuropathy or partial paralysis
- Pressure in the head
- Numbness in body, tingling, pinpricks
- Poor balance, dizziness, difficulty walking Increased motion sickness
- Lightheadedness, wooziness
- Mood swings, irritability, bi-polar disorder
- Unusual depression
- Disorientation (getting or feeling lost)
- Feeling as if you are losing your mind
- Over-emotional reactions, crying easily
- Too much sleep, or insomnia
- Difficulty falling or staying asleep
- Narcolepsy, sleep apnea
- Panic attacks, anxiety
- Memory loss (short or long term)
- Confusion, difficulty in thinking
- Difficulty with concentration or reading
- Going to the wrong place
- Speech difficulty (slurred or slow)
- Stammering speech
- Forgetting how to perform simple tasks
Reproduction and Sexuality
- Loss of sex drive
- Sexual dysfunction
- Unexplained menstrual pain, irregularity
- Unexplained breast pain, discharge
- Testicular or pelvic pain
- Unexplained weight gain, loss
- Extreme fatigue
- Swollen glands/lymph nodes
- Unexplained fevers (high or low grade)
- Continual infections (sinus, kidney, eye, etc.)
- Symptoms seem to change, come and go
- Pain migrates (moves) to different body parts
- Early on, experienced a “flu-like” illness, after which you have not since felt well.
- Low body temperature
- Allergies/Chemical sensitivities
- Increased effect from alcohol and possible worse hangover
This list is long and all of these symptoms, alone, could be the result of something else. However, if you have many, they change on a regular basis (some are cyclical or hormonal), and affect numerous systems, chances are you may have Lyme disease and/or another tick borne disease.
Another good symptom list is on the Canadian Lyme Disease Foundation (CanLyme) website at www.canlyme.com.
Dr. Richard Horowitz, one of the best known Lyme Literate Doctors in the world, and who has written the book “Solving the Mystery of Lyme & Chronic Disease”, has a diagnostic form to fill out which gives you an idea whether a possible Lyme diagnosis should be pursued – https://docs.google.com/viewer?a=v&pid=sites&srcid=ZGVmYXVsdGRvbWFpbnxjYW5nZXRiZXR0ZXIyfGd4OjViM2FhOTFjYWViY2RmNzI.
Ticks can also carry more than one disease! Depending upon where you live, the co-infections can vary.
Here are a few co-infections that have been found in Canada:
Anaplasmosis – http://www.cdc.gov/anaplasmosis/symptoms/
Ehrlichiosis – https://www.cdc.gov/ehrlichiosis/
Babesiosis – http://www.cdc.gov/parasites/babesiosis/
Powassan Virus – http://www.cdc.gov/powassan/
Borrelia miyamotoi – http://www.cdc.gov/ticks/miyamotoi.html
Rocky Mountain Spotted Fever (found in dog ticks) – http://www.cdc.gov/rmsf/
Bartonella (recent research from Dal indicates that many ticks – both black-legged and dog/wood – are carrying Bartonella) – http://columbia-lyme.org/patients/tbd_bartonella.html
Tularemia – https://www.cdc.gov/tularemia/index.html
Other tick borne diseases are always possible as migratory birds bring more and more ticks from a number of areas.
INFORMATION YOU SHOULD HAVE FOR YOUR DOCTOR’S VISIT:
Before you head to your GP to discuss tick borne diseases, you should be armed with some general information as the knowledge of many Doctors on ALL stages of Lyme and Tick Borne Diseases is still sorely lacking. First of all, you should have either printed off a symptom list from CanLyme or the Murakami Centre for Lyme and checked off all symptoms that apply, or completed Dr. Horowitz’s questionnaire.
You should have a copy of the Canadian Adverse Reaction Newsletter, Volume 22 – Issue 4 – October 2012 – https://www.canada.ca/en/health-canada/services/drugs-health-products/medeffect-canada/health-product-infowatch/canadian-adverse-reaction-newsletter-volume-22-issue-4-october-2012.html. This newsletter refers to test limitations. The ELISA is not 100% accurate. There have been actual laws passed in some US states requiring Doctors to advise patients that a negative ELISA does not mean that they don’t have Lyme. However, the ELISA, and then the Western Blot if the ELISA is positive or equivocal, are the blood tests undertaken in Canada at this time.
If you have the tell-tale bull’s eye rash (which is a definite sign of Lyme – no testing required), or any other type of rash, you should take a photo of the rash and note the date, the size and where you were bitten (both on body and location – if known), as it might disappear before you get to the Doctor. There are a variety of rashes possible and other things that ticks can transmit can also result in a rash. An erythema migrans rash generally grows in size over time.
You should also either have a copy of, or at least be knowledgeable about, the CDC website page regarding untreated Lyme symptoms as many Doctors still believe that Lyme is nothing more than a rash and flu-like symptoms – https://www.cdc.gov/lyme/signs_symptoms/index.html. They would be wrong!
If in Nova Scotia, you should have a copy of the Nova Scotia Statement for Managing Lyme disease document – http://novascotia.ca/dhw/cdpc/documents/statement_for_managing_LD.pdf. The Statement for Managing LD also includes some general treatment guidelines and, although I don’t agree with everything it says as it still follows the outdated IDSA guidelines, it should get your Doctor started in the right direction. Along with this Statement, you should also have this note on the IDSA website – http://www.idsociety.org/Guidelines_Patient_Care/. They are guidelines only!
Also helpful, if in Nova Scotia, is a copy of the Department of Health & Wellness, Communicable Disease Prevention and Control document that includes a Nova Scotia risk map that shows all of Nova Scotia at risk – https://novascotia.ca/dhw/CDPC/lyme.asp. There is also a Nova Scotia Tick Borne Diseases Response Plan which mentions possible co-infections – https://novascotia.ca/dhw/CDPC/documents/Tick-Borne-Disease-Response-Plan.pdf, but doesn’t include all that have been found in the province.
You should print off a copy, or at least have knowledge, of “Evidence assessments and guideline recommendations in Lyme disease: the clinical management of known tick bites, erythema migrans rashes and persistent disease” – http://informahealthcare.com/doi/full/10.1586/14787210.2014.940900. This is a more up-to-date standard of care guideline for treating Lyme and other tick-borne illnesses which was released by the International Lyme & Associated Diseases Society (ILADS) in July of 2014. These guidelines can now be found on the federal government website – https://www.canada.ca/en/public-health/services/diseases/lyme-disease/health-professionals-lyme-disease.html under “For More Information” at the bottom of the page.
It is also important to know that although it has not been determined that dog(wood) ticks can carry Lyme disease, they have been found to be carrying other things in Nova Scotia. There is a research group at Dalhousie University that has found Rickettsia, Bartonella, Tularemia, etc.
You might want to also print off, or at least review before your appointment, the recently released Federal Framework on Lyme Disease – https://www.canada.ca/content/dam/phac-aspc/documents/services/publications/diseases-conditions/lyme-disease-canada-federal-framework/lyme-disease-canada-federal-framework-eng.pdf .
What would also be helpful is information on possible co-infections. The best spot I have found so far is IDEXX Laboratories which is for pet testing. At least it gives you an idea of some co-infections that are in your area. However, not every Veterinarian uses this Lab so it is only a sampling and doesn’t include tests for everything that could be carried by ticks – http://www.petdiseasereport.com/content/prevmap.aspx.
A few links and information that might be helpful to those in Newfoundland:
Jean Hewson is the CanLyme Representative for Newfoundland/Labrador – Jean Hewson
Email: email@example.com Tele is 709-722-2863
NEW BRUNSWICK INFO:
There are a number of CanLyme contacts available in New Brunswick – https://canlyme.com/about/contact/
Mount Allison University, with the support of the Canadian Lyme Disease Foundation, has established a Lyme disease research node led by Dr. Vett Lloyd – https://www.mta.ca/Community/Research_and_creative/Tick_and_Lyme_disease_research/Tick___Lyme_disease_research/.
LymeNB is the registered business name for the incorporated not-for-profit New Brunswick Lyme Disease Association Inc., founded in 2016 and granted charitable status in 2018. Its purpose is preventing tick-borne illnesses, while supporting and being a voice for those affected. Membership is open, at no cost, to anyone touched by Lyme disease. Its members come from all over the province and have nearly tripled since LymeNB was incorporated. Membership application forms to join LymeNB are available on its website (www.lymenb.ca) as is contact information for its President, Janet Higgins and the facilitators for its two support groups, one in the Greater Moncton Area (Cathie Smith) and the other in the Greater Fredericton Area (Louise Billings).
LymeNB has a Facebook page (www.facebook.com/lymenb.ca), as well as a closed virtual support group site (www.facebook.com/lymechatnb.) LymeNB offers seminars and conferences on Lyme disease to targeted groups as well as to the general public and carries out various activities to raise awareness about Lyme disease and co-infections and to provide supportive healthcare services to its members. If you wish to reach LymeNB, please write to firstname.lastname@example.org
There is a Facebook page – “Tick Talk NB – Lyme Disease and other tick borne illnesses” – https://www.facebook.com/TickTalkNB/.
An excellent series was recently done by CBC Information Morning, Moncton called “A Matter of Lyme”: Vett Lloyd – Lyme Disease – http://www.cbc.ca/player/play/2696340214. There was also an interview with a Lyme sufferer (Natasha Joy Snowden), her Naturopath (Dr. Nicholas Anhorm) and her Doctor (Dr. Richard Dubocq of Albion, Maine).
– http://www2.gnb.ca/content/gnb/en/departments/ocmoh/cdc/content/vectorborne_andzoonotic/lyme.html (basically included as it mentions that ticks can be anywhere in New Brunswick and it includes some possible symptoms of untreated Lyme disease)
While looking for info, I came across these. At least some politicians are trying:
– Motion 17 (page 5/6) is very interesting – http://www.gnb.ca/legis/business/currentsession/58/58-2/order-e/o160212e.pdf
– Motion 17, yet again – http://www.gnb.ca/legis/business/currentsession/58/58-2/order-e/o160405e.pdf. Unfortunately, the Motion, as presented, did not get approved – http://www.gnb.ca/legis/business/currentsession/58/58-2/journals-e/27160407e.pd
There is a new CanLyme contact person in PEI – Chris Robinson, Email: email@example.com , Tele 902-628-9831
Very little general info about Lyme in PEI was found on-line, but this is a start:
– From a Feb. 2007 Newsletter of the Diagnostic Services Laboratory, Atlantic Veterinary College, “The Presence of Ixodes scapularis ticks and the Potential for Lyme Disease on Prince Edward Island” – http://files.upei.ca/avc/diagnosticservices/newsletters/avcds_feb2007_vol1-01.pdf
Alternative testing is available but the results are generally not accepted by non “Lyme Literate” Doctors so the information is more for your own peace of mind or that of your Naturopath or LLMD. Testing is not cheap and is probably going to be out-of-pocket. You may want to consider having a free “consult” with Dr. Ernie Murakami (http://www.murakamicentreforlyme.org) so that you can get an idea of what co-infections you might have and see if testing for any of them is available via the mainstream medical field as a good start. Dr. Murakami is a retired Doctor in Hope, BC, who has made it his mission to educate about Lyme and tick borne diseases. There are also some symptom lists of possible co-infections included in this information document. Co-infections are becoming more and more common and can hinder treatment so trying to find out what you have in that regard is just as important, if not more so, than Lyme.
The three main private Labs that I am aware of are:
The following would be useful information to have if you are going to go the route of private testing:
There is a lot of research going on around the world. Unfortunately, it doesn’t seem to be getting shared so there are now several spots where Lyme research is being recorded. One is a Facebook page that I started in an effort to keep track of up and coming research. I obviously don’t see it all but it’s a starting point – Research Information for Tick Borne Diseases (Lyme, Babesiosis, etc.) – https://www.facebook.com/groups/226575537496968/
The following are some research documents that I refer to frequently:
– An interesting research document worth a read – “Co-Infection of Ticks: The Rule Rather Than the Exception” – http://journals.plos.org/plosntds/article?id=10.1371%2Fjournal.pntd.0004539
– CMAJ – “The emergence of Lyme disease in Canada” – www.cmaj.ca/content/180/12/1221.full.
– Lyme and associated tick-borne diseases: global challenges in the context of a public health threat – www.ncbi.nlm.nih.gov/pmc/articles/PMC4042490/pdf/fcimb-04-00074.pdf.
– Health Care Costs, Utilization and Patterns of Care following Lyme Disease – www.journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0116767.
– Lyme Arthritis: An Emerging Clinical Problem in Nova Scotia, Canada – http://onlinelibrary.wiley.com/doi/10.1002/art.38498/full
The following websites are reasonably good sources of information. The Scoop.it page and Facebook page are ones I started. There is a conflicting school of thought on Lyme disease and co-infections so always do your homework! I try to post information from both sides so that you can make an informed decision.
Public Health Agency of Canada – Lyme Disease – www.phac-aspc.gc.ca/id-mi/lyme-eng.php.
Public Health Agency of Canada Lyme Disease Fact Sheet – www.phac.gc.ca/id-mi/lyme-fs-eng.php
Government of Canada – Lyme disease – www.healthycanadians.gc.ca/health-sante/disease-maladie/lyme-eng.php.
The Canadian Lyme Disease Foundation – www.canlyme.net. CanLyme also has a YouTube Channel with videos from the Federal Framework on Lyme Disease Conference held in Ottawa in May of 2016. Worth checking out.
The Canadian Lyme Science Alliance – http://www.lymesciencealliance.org/.
Dr. E. Murakami Centre for Lyme Research, Education & Assistance Society – www.murakamicentreforlyme.org
International Lyme and Associated Diseases Society (ILADS) – www.ilads.org.
University of Rhode Island TickEncounter Resource Center – http://www.tickencounter.org/.
The following articles/interviews are also good sources of information. There are many more as well. These are just a sampling:
– Andrew Rankin, a journalist with The Chronicle Herald, has written several articles recently about Lyme, Tick borne diseases and ticks. Worth checking out. Dr. Robert Strang, Nova Scotia’s Chief Medical Officer, has actually written a rebuttal to some of the “misinformation”. Further “Letters to the Editor” were written responding to Dr. Strang’s article. All worth a read.
– Fox5 NY has done a number of excellent interviews on the issue of Lyme and Tick Borne Diseases – http://www.fox5ny.com/lyme-disease
– An interview with Dr. Alfred Miller – NightSide – A New Perspective on Lyme Disease – https://player.fm/series/nightside-with-dan-rea-1511437/nightside-a-new-perspective-on-lyme-disease.
– Doctor’s Review – “Lyme disease: past, present and future” – http://doctorsreview.com/history/lyme-disease-past-present-and-future/
– “The peril of chronic Lyme disease” by Mary Beth Pfeiffer – http://www.newsday.com/opinion/commentary/the-peril-of-chronic-lyme-disease-1.13775806.
– CDC’s Profile Plummets While 15 Government Authorities Act on Persistent and Disabling Lyme Disease – https://www.linkedin.com/pulse/cdcs-profile-plummets-while-15-government-authorities-luche-thayer
– CDC advises you might need multiple Lyme disease tests after a tick bite – http://abcnews.go.com/GMA/video/cdc-advises-multiple-lyme-disease-tests-tick-bite-48364357.
– Lyme Disease: Inside America’s Mysterious Epidemic – http://www.rollingstone.com/culture/features/lyme-disease-inside-americas-mysterious-epidemic-w487776.
– Lyme disease research, funding falling behind in Canada – http://www.cbc.ca/news/canada/manitoba/opinion-seiff-lyme-disease-1.4165151
– Nightside – Talking with a Lyme Disease Expert – http://boston.cbslocal.com/2017/05/24/nightside-talking-with-a-lyme-disease-expert/
– Tick Talk: How Lyme disease has more reach than HIV/AIDS – http://abc27.com/2017/03/03/tick-talk-how-lyme-disease-has-more-reach-than-hivaids/
– Press Conference: Improving the Lyme Disease Framework – https://www.youtube.com/watch?v=1LkglyEVBw8
– Lyme and Reason: Dr. Steven Phillips Interview, Fox5NY – https://www.youtube.com/watch?v=Fy0ViOX7xNk&feature=share
– Does Chronic Lyme Disease Exist – http://www.contagionlive.com/videos/does-chronic-lyme-disease-exist
– Lyme Disease: Experts Weigh in on the Controversies – http://www.americanveterinarian.com/journals/amvet/2017/february2017/lyme-disease-experts-weigh-in-on-the-controversies
– An excellent video prepared by the Stand4Lyme Foundation. Ten of the world’s top scientists from leading institutions discuss their scientific insights on the problems and potential solutions for Lyme disease. – “Lyme in the 21st Century” – https://www.youtube.com/watch?v=JYhY7tquUOo.
– A fairly high percentage of dog ticks in Nova Scotia could carry Rocky Mountain Spotted Fever – http://www.cbc.ca/news/canada/nova-scotia/lyme-disease-deer-ticks-may-not-be-the-only-ones-we-have-to-worry-about-1.3060683
– Good co-infection information – http://canlyme.com/just-diagnosed/co-infections/specific-co-infections/
– This is from the US but gives some more info on possible co-infections. In Nova Scotia, Babesiosis, Powassan Virus, Bartonella, Borrelia miyamotoi, and Rocky Mountain Spotted Fever have been found in ticks but that’s not to say other things are not also present. They just haven’t been found yet! – https://www.lymedisease.org/lyme-basics/co-infections/about-co-infections/
– A comparison chart of possible symptoms of co-infections – http://www.lyme-symptoms.com/LymeCoinfectionChart.html
– A misdiagnosis (or two or three) appear to be quite common with people that did not see the tick or a bull’s eye rash. Here are some things you could possibly be misdiagnosed with – http://canlyme.com/just-diagnosed/testing/common-misdiagnoses/
– An excellent interview with Dr. Neil Spector with regard to his thoughts on Lyme after his own journey- http://www.huffingtonpost.com/dana-parish/lyme-the-infectious-disea_b_9243460.html.
– The following two news articles note that Powassan Virus has been found in Nova Scotia ticks – www.cbc.ca/news/canada/toronto/powassan-virus-prompts-officials-to-expand-tick-monitoring-1.3036326 and http://www.ctvnews.ca/health/health-officials-ramp-up-testing-for-rare-powassan-virus-1.2330280.
– CBC – Ticked Off: The Mystery of Lyme Disease – http://www.cbc.ca/natureofthings/episodes/ticked-off-the-mystery-of-lyme-disease. Lots of extra info on the site as well, including interviews with Doctors, etc. This TV show was made into a very informative DVD worth watching as well.
– Orchard TV – Live webcast with Vanessa Farnsworth, writer of “Rain on a Distant Roof: A Journey Through Lyme Disease in Canada” – www.orchardtv.com/vanessafarnsworth/.
– The Daily Climate – “Lyme disease surges north, and Canada moves out of denial” – www.dailyclimate.org/tdc-newsroom/2014/09/canada-lyme-disease-spreads. The person that wrote this, Marianne Lavelle, also wrote several other articles around the same time that are worthy of reading.
– MacLean’s – “Health Canada’s new Lyme disease plan: You Act, We’ll Watch” – http://www.macleans.ca/society/health/health-canadas-new-lyme-disease-plan-you-act-well-watch/
– CTV News – “Why are crippling Lyme disease cases being misdiagnosed?” – www.ctvnews.ca/why-are-crippling-lyme-disease-cases-being-misdiagnosed-1.453946.
There are lots of different Facebook Pages and Groups on Lyme Disease but the following one was started to try and track the issue in Nova Scotia – “Lyme Disease in Nova Scotia & the Atlantic Provinces” or visit: www.facebook.com/pages/Lyme-Disease-In-Nova-Scotia/217895438247422. There is also a “Nova Scotia Lyme Disease Registry” which was started in an effort to have a place where those dealing with Lyme disease in Nova Scotia could be counted. The page can be found at www.facebook.com/groups/253938431456967/.
There is also a “Lyme Support Group – Maritime Provinces” Facebook group for those unable to attend a support group in person.
For those not on Facebook, but with access to a computer, two Scoop.it pages dedicated to tick borne diseases have been created by Donna Lugar – “Lyme Disease & Other Tick Borne Diseases” – www.scoop.it/t/lyme-disease-other-tick-borne-diseases and “Tick Borne Diseases in Canada (including Lyme, Bartonella, Babesiosis, Anaplasmosis, etc.)” – www.scoop.it/t/tick-borne-diseases-in-canada.
Many pages dedicated to Lyme and other tick borne diseases. Donna Lugar’s is http://www.pinterest.com/donnalugar/lyme-disease-other-vector-borne-diseases-bartonell/.
FILM – “UNDER OUR SKIN”
Donna Lugar has purchased a copy of the award-winning documentary about Lyme disease called “Under our Skin” (www.underourskin.com), including public performance rights. If you wish to borrow the film for a group viewing, please contact Donna Lugar 902-835-5643 or firstname.lastname@example.org.
FILM – “TICKED OFF: THE MYSTERY OF LYME DISEASE”
Donna Lugar has purchased a copy of “Ticked Off: The Mystery of Lyme Disease”. There are two discs with the second disc including extended Lyme Expert Interviews. Disc one includes the show (52 minutes – different than the one shown on the Nature of Things), Lyme Expert Interviews and Lyme Patient Testimonials. This is available for personal and public viewing as performance rights were purchased. A version of this film is also available for viewing at www.cbc.ca/natureofthings/episodes/ticked-off-the-mystery-of-lyme-disease but it is the TV version not the DVD version. The DVD version is much better.
FILM – “UNDER OUR SKIN 2 – EMERGENCE”
Donna Lugar has purchased a copy of “Under Our Skin 2 – Emergence”. If you wish to borrow the film to view or for a group viewing, please contact Donna Lugar at 902-835-5643 or email@example.com.
LYME SUPPORT GROUPS IN NOVA SCOTIA
A Lyme Support Group has been started in the Bedford area. Meetings are posted on the Facebook page and are generally the second Monday of the month starting at 6:30 pm. The location for the next year is the meeting room in the Northwood Bedford Campus (Ivany Place) at 123 Gary Martin Drive. Use the main entrance to the building. All those dealing with tick borne diseases are welcome, including Support/Family members. Contact person is Donna Lugar, firstname.lastname@example.org. You can contact Donna and ask to be put on an email list for meeting reminders/notices.
A Lyme Support Group had also been started in the Bridgewater area; however, the contact person has stepped down and a replacement is being looked for. If interested, please let Donna Lugar know at email@example.com.
There are many other areas throughout the province that could use Lyme Support Groups, especially for those not on social media. Anyone interested in starting one can contact Donna for suggestions.
For those on social media, there are lots of Facebook pages/groups that have started up. A good one for Canadians is Lyme: “OhOh Canada”.
LYME SUPPORT GROUPS IN NEW BRUNSWICK
LymeNB is the registered business name for the incorporated not-for-profit New Brunswick Lyme Disease Association Inc., founded in 2016 and granted charitable status in 2018. Its purpose is preventing tick-borne illnesses, while supporting and being a voice for those affected. Membership is open at no cost to anyone touched by Lyme Disease. Its members come from all over the province and have nearly tripled since LymeNB was incorporated. Membership application forms to join LymeNB are available on its website (www.lymenb.ca) as is contact information for its President, Janet Higgins and the facilitators for its two support groups, one in the Greater Moncton Area (Cathie Smith) and the other in the Greater Fredericton Area (Louise Billings). Contact info on the LymeNB website.
LymeNB has a Facebook page (www.facebook.com/lymenb.ca) as well as a closed virtual support group site (www.facebook.com/lymechatnb.) LymeNB offers seminars and conferences on Lyme Disease to targeted groups as well as to the general public and carries out various activities to raise awareness about Lyme disease and co-infections and to provide supportive healthcare services to its members.
If you wish to reach LymeNB, please write to firstname.lastname@example.org.
HEALTH CARE PROVIDERS
The following contact information is for Doctors/Naturopaths that some Support Group Members are using. This list in no way implies that I have vetted them all and am recommending their services. They are just for your information and research. They are in no particular order.
– Dr. Risk, a Naturopath in Calgary. She will work with you over the phone and/or via Skype. Her website is www.dr-risk.com. Her phone number is 403-879-1686. You can email her via her website. There is a YouTube video with Dr. Risk that you may be interested in checking out.
– Dr. Chan, a Naturopath in Richmond, BC (BC Naturopaths are able to prescribe antibiotics) – http://pannaturopathic.com/ He was interviewed in the CBC Nature of Things show about Lyme.
– Dr. Julie Moore, a Naturopath in Vancouver – http://www.sageclinic.com/doctor/dr-julie-moore-nd/. I was given this Naturopath’s name by Jim Wilson, President, Canadian Lyme Disease Association (CanLyme). Apparently he has been hearing good things about her and, as noted for Dr. Chan, BC Naturopaths can prescribe antibiotics.
– Dr. Maureen McShane in Plattsburgh, NY also comes highly recommended. Her phone number is 518-324-5548. Her email is email@example.com. Plattsburgh, NY is just over the border from Montreal.
– Dr. Ernie Murakami (retired) of the Dr. E. Murakami Centre for Lyme has a website and will provide advice, free of charge. His website is www.murakamicentreforlyme.org. There is a questionnaire on his site that you can fill out and fax to him so that he can make a clinical diagnosis of tick borne diseases. He was instrumental in helping me learn what was wrong with me back in 2011. He is also on Facebook.
– Dr. Bryan Rade is a Naturopath in Bedford (he has moved) that describes himself as being fairly knowledgeable about tick borne diseases. Some have had good results with him. He is East Coast Naturopathic Clinic – https://www.eastcoastnaturopathic.com/
– Dr. Nicholas Anhorn is a Naturopath in Moncton – http://monctonnaturopathic.com/practitioners/dr-anhorn/. He is a member of ILADS.
– Dr. Melissa Blake, a Naturopath that practices out of Dieppe, NB and Amherst, NS. Her practice is “The Pear Tree Naturopathic Clinic” – www.thepeartreeclinic.com.
– Dr. Sandra Murphy, a Naturopath in Halifax – http://nurturetherapeutics.ca.
– Dr. Ben Connelly, a Naturopath in Tantallon, NS – http://cornerstonenaturopathic.ca/
– Dr. Lois Hare, Valley Naturopathic in Berwick – http://nsand.ca/members/dr-lois-hare-nd-berwick/
– Dr. Fronie LeRoy, OMD PHD at the Baidu Traditional Chinese Medicine Clinic at 1242 Bedford Highway (902-444-4724 – www.baidutcm.ca) has started learning more about Lyme disease and co-infections. Dr. LeRoy does TCM, Acupuncture and Homeopathics. She is presently treating people with Lyme, with some success.
– Terry Sheehy of Mother Nature’s Natural Therapy – https://www.mothernaturesnaturaltherapy.com in Bedford, NS, has taken an interest in all things Lyme (and co-infections) and utilizes a variety of treatments.
– There are Medical Herbalists in Nova Scotia that apparently have treatments for Lyme/tick borne diseases – http://herbalns.org/
– Dr. Richard Dubocq in Albion, Maine (Unity Rd, Albion, ME 04910, USA, +1 207-437-5500) is seeing quite a few Canadian Lyme patients. He is closer to us than others and is apparently somewhat cheaper as he has low overhead. He was interviewed by CBC Information Morning, Moncton, for a series they did on Lyme – http://www.cbc.ca/player/play/2696239815.
– Dr. Ralph Hawkins is one of a very short list of Canadian “Lyme Literate” Doctors that are actively treating Lyme at this time. He is located in Calgary. He has a fairly long wait time (generally over a year I believe) and you have to be referred to him. Unfortunately, at present, Dr. Hawkins is no longer accepting referrals from outside of Alberta in an effort to get his wait list down to a manageable level. http://globalnews.ca/news/2830195/calgary-doctor-speaks-out-against-one-size-fits-all-treatment-for-lyme-disease/.
The following was received from ILADS in response to a request for the names of ILADS trained medical professionals in or near Nova Scotia. Hopefully, more names get added to this list on a regular basis. They are very quick to respond:
“Please understand that the International Lyme and Associated Diseases Society, Inc. (‘ILADS’) is not a healthcare provider and does not give medical advice or provide treatment. When requested, ILADS will provide contact information of our medical members located in particular geographic regions. While ILADS endeavors to evaluate an individuals’s educational qualifications for membership, ILADS does not evaluate or warrant a member’s professional qualifications, professional competence, or skill.
The fact that ILAD’s has provided the member’s name and contact information does not constitute a recommendation of the member. Most importantly, ILADS does not certify or warrant the quality of care you will receive from any ILADS member. You are responsible for selecting a suitable health care provider. In doing so, you should evaluate all information you deem relevant, including but not limited to the individual’s background, training, experience, and reputation. In addition, ILADS does not maintain insurance information on its members. As a condition of your using any information ILADS has provided to you about a member, you agree that ILADS shall not be liable to you or others for any decision you or others make, or action that you or others take in reliance on such information. Further, you agree that ILADS shall not be liable to you or others for any acts, omissions, or services of any ILADS member. –
The closest ILADS members –
Beatrice Szantyr MD, Lincoln, ME 207 794 6405
Penelope Houghton ND, Ellsworth ME 207 664 0780
Nicholas Anhorn ND, Moncton, NB, Canada 506 382 1329
Lyme Patient Advocacy: Lyme Disease United Coalition (US and Canada), www.lduc.org, tel. 800 311 7518
There are various alternative treatments that people have been using and recommend. Of course, everyone is different so you have to do your own research. Some of these would be considered quite “out there” and many require additional research if you are interested as some can interfere with other treatments. This is just food for thought.
Dietary Changes – It is generally recommended to eat as “clean” as possible. No processed foods. Limit or remove sugar. No artificial sweeteners. Gluten may become an issue. Limit or remove dairy. Red meat may cause gastrointestinal issues for some. Caffeine and alcohol should be avoided. www.drrajpatel.net/index.php/lyme-m/lymediet-m
Adding turmeric or cumin to your diet – http://www.mnn.com/food/healthy-eating/stories/the-amazing-health-benefits-of-turmeric
Drinking warm lemon water first thing in morning – http://www.lifehack.org/articles/lifestyle/11-benefits-lemon-water-you-didnt-know-about.html
Oil Pulling – I have personally been doing this for over three years. Love it! – http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3131773/
Apple Cider Vinegar – A tablespoon in a glass of water before meals – This one was suggested to me by a Naturopath to aid digestion. – http://www.cosmopolitan.com/health-fitness/a48500/apple-cider-vinegar-benefits/.
Garlic – Rumor has it that ticks don’t like the smell of garlic and it has actually been used to spray on the perimeters of lawns in an effort to keep them off. I have been told by some that eat regular garlic that they have never found a tick on themselves, even when they spend a considerable amount of time outdoors. Hmmm – “Garlic Can Fight Chronic Infections” – http://healthsciences.ku.dk/news/2017/11/garlic/
Vitamin A Supplementation – “Vitamin A Deficiency Exacerbates Murine Lyme Arthritis” – https://academic.oup.com/jid/article/174/4/747/812942
Tinidazole/Clarithromycin – This combo has apparently been used by some with great success. You need a prescription. Tinidazole, 500mg –twice daily; Clarithromycin, 500mg-twice daily.
Take one of each TOGETHER at least 30 days or 60 days if necessary. (This info was received from someone using it. I have no personal knowledge.)
Colloidal Silver – http://www.thehealthyhomeeconomist.com/never-consume-colloidal-silver/ and, for a different opinion https://nccih.nih.gov/health/silver
Acupuncture & Traditional Chinese Medicine – http://www.kaplanclinic.com/videos/chinese-medicine-gu-syndrome-lyme-disease/.
Rife machine – https://www.cancertutor.com/lymedisease/
Low dose immunotheraphy (LDI) – http://www.treatlyme.net/treat-lyme-book/ldi-bring-on-the-regulators/.
Cowden Protocol – Lots of information available on this protocol. This is just one of many – http://www.lyme-disease-research-database.com/lyme_disease_blog_files/tag-cowden-protocol.html.
Buhner Protocol – http://buhnerhealinglyme.com/.
There are may more things out there that people have tried. Something that works for one, may not work for another. Lyme and tick borne diseases seems to be a very individualized illness for many.
LAST, BUT NOT LEAST
– As mentioned, I have a few different places where I post info on Lyme disease and co-infections:
– A facebook page – www.facebook.com/pages/Lyme-Disease-in-Nova-Scotia-the-Atlantic-Provinces/217895438247422. This is an open group.
– A private, closed, Lyme Support Group – Maritime Provinces Facebook group – https://www.facebook.com/groups/553427674708798/.
– A facebook group for Research Info – www.facebook.com/groups/226575537496968.
– A facebook group for non Maritime province related info – Tick/Vector Borne Disease (Lyme, Bartonella, etc.) Sufferers Unite – www.facebook.com/groups/261243560639881/.
– A Scoop.it page – Lyme Disease & Other Vector Borne Diseases – www.scoop.it/t/lyme-disease-other-tick-borne-diseases.
– Another Scoop.it page – Tick Borne Diseases in Canada (including Lyme, Bartonella, Babesiosis, Anaplasmosis, etc.) – www.scoop.it/t/tick-borne-diseases-in-canada.
I also have a Facebook group where people can speak up and be counted called “Nova Scotia Lyme Disease Registry – https://www.facebook.com/groups/253938431456967/. It’s a closed group but if you, or a family member are dealing with Lyme and/or co-infections, would like to be “counted” please ask to join.
As an FYI, I also have a Pinterest page dedicated to Lyme disease and utilize Twitter and LinkedIn. As another FYI, there is a Lyme Support Group on LinkedIn. I also utilize Tumblr, Instagram and WordPress to raise awareness.
I have some resource information that I would be willing to loan out if anyone is interested. Along with the DVD’s mentioned above, I also have several books on Lyme. The first one that I ever read was “Ending Denial – The Lyme Disease Epidemic, A Canadian Public Health Disaster”. That was very eye opening. I also have “Healing Lyme Disease Coinfections” by Stephen Buhner; Dr. Horowitz’s book “Why Can’t I Get Better”, Lori Dennis’ book called “Lyme Madness” and Connie Strasheim’s book “New Paradigms in Lyme Disease Treatment”. I will loan them out so you can check to see if you would be interested in buying.
COMMON LYME DISEASE ABBREVIATIONS & DEFINITIONS
AMMI – Association of Medical Microbiology and Infectious Disease Canada
Abx – antibiotics
Bb – Borrelia burgdorferi – a bacterial species of the spirochete class of the genus Borrelia.
Babs – Babesiosis/Babesia – malaria-like protozoans that parasitize and reproduce within mammalian red blood cells.
Bart – Bartonella – Bartonellosis – an infectious disease produced by bacteria of the genus Bartonella. Bartonella species cause diseases such as Carrión’s disease, trench fever, cat-scratch disease, bacillary angiomatosis, peliosis hepatis, chronic bacteremia, endocarditis, chronic lymphadenopathy, and neurological disorders
Bell’s palsy – loss of muscle tone or droop on one or both sides of the face
CACMID – Canadian Association for Clinical Microbiology and Infectious Diseases
CDC – Centers for Disease Control and Prevention
CPHO – Chief Public Health Officer
CanLyme – Canadian Lyme Disease Foundation
Co-Infections – Some ticks carry pathogens along with, or instead of, Lyme, that can cause human disease, including Anaplasmosis, Babesiosis, Borrelia miyamotoi, Powassan virus, Rocky Mountain Spotted Fever, Ehrlichiosis, Bartonella, and many others.
EM – Erythema Migrans or “bull’s eye” rash.
ELISA – Enzyme-linked immunosorbent Assay, a rapid immunochemical test that involves an enzyme used for measuring a wide variety of tests of body fluids
Herx – Jarisch-Herxheimer or Herxheimer reaction – an increase in symptoms of a spirochetal disease occurring in some persons when treatment is started
ID – Infectious Disease
IgE – Immunoglobulin E – a type of antibody which is associated mainly with allergic reactions
IgG – Immunoglobulin G – a type of antibody which is found in all body fluids and protects against bacterial and viral infections
IgM – Immunoglobulin M – a type of antibody which is found mainly in the blood and lymph fluid. It is the first antibody to be made by the body to fight a new infection
IV – Intravenous
LD – Lyme disease – an acute inflammatory disease that is caused by a spirochete (Borrelia burgdorferi) transmitted by ticks (and possibly other vectors, research ongoing).
IDSA – Infectious Disease Society of America
ILADS – International Lyme and Associated Diseases Society
LLMD/LLND – Lyme Literate Medical Doctor/Lyme Literate Naturopathic Doctor
Late Stage (better known as “Chronic”) Lyme – Untreated, or undertreated, Lyme disease, weeks, months or years after tick bite
Lyme carditis – heart palpitations or an irregular heart beat
NP – Nurse Practitioner
Neuro – neurology, neurological
PHAC – Public Health Agency of Canada
PHC – Public Health Canada
PTLDS – Post-treatment Lyme Disease Syndrome – a CDC reference to symptoms experienced after treatment
RX – prescription
RMSF – Rocky Mountain Spotted Fever
SX – symptom
TBD – Tick Borne Disease
TBI – Tick Borne Illness
WB – Western Blot – https://www.cdc.gov/lyme/diagnosistesting/labtest/twostep/westernblot/index.html
I hope this was helpful. Feel free to provide me with any additional information you think should be included.