Although May is generally known as Lyme Disease Awareness Month, awareness should be year-round as ticks can be active any month of the year in many parts of the world, including in Nova Scotia.

I posted a fact on my Twitter account for every day of May, 2022, and I’ve compiled them all here for year-round information. I have also provided some additional info/links. Most links are not “live” for some reason so you will have to cut and paste.

Fact #1 – Although a bull’s-eye pattern is the best known Lyme rash, it is one of the least common of the erythema migrans (EM) Lyme rashes – https://www.health.com/condition/lyme-disease/lyme-disease-rashes and https://www.cdc.gov/lyme/resources/NCEZID_rash_poster3r1-508.pdf.

Fact #2 – Proper tick removal is very important. Don’t squeeze the tick’s body, cover to smother, spin it with a Q-tip, or burn it with a match – https://www.canada.ca/en/public-health/services/video/lyme-disease-properly-remove-tick.html.

Fact #3 – Ticks do not fly or jump. They wait for a host, in a position known as “questing”, on the tips of grass or shrubs.

Fact #4 – Lyme carditis is when the Lyme bacteria, Borrelia burgdorferi, attacks the heart – https://www.cmaj.ca/content/190/20/E622. If not caught in time, and appropriately treated, it can lead to death. Once thought to be very rare, cases are growing.

Fact #5 – Blacklegged ticks are not the only ticks carrying diseases and Lyme isn’t the only thing we need to worry about. Educate yourself – https://www.cdc.gov/ticks/diseases/index.html. Although this is US specific, many of these can be found here in Nova Scotia, and elsewhere.

Fact #6 – If spending a lot of time outdoors, permethrin treated clothing and gear are helpful tools for tick bite prevention. However, daily tick checks are still very important.

Fact #7 – There are now made in Canada guidelines for Early localized/Acute Lyme. Although not 100%, they are better than the IDSA guidelines – https://cep.health/clinical-products/early-lyme-disease/.

Fact #8 – The prophylactic dose prescribed by pharmacists for a tick bite is based on limited research – https://www.ncbi.nlm.nih.gov/books/NBK545493/.

Fact #9 – Although it generally (but not always) takes some time for Lyme to be transmitted once a tick attaches, Powassan virus has been found to transmit in as quickly as 15 minutes.

Fact #10 – Without a test that can accurately diagnose Lyme 100% of the time, this diagnostic tool should be on everyone’s radar – GSQ-30 – https://www.frontiersin.org/articles/10.3389/fmed.2019.00283/full.

Fact #11 – If not treated or treated appropriately, there can be three stages to Lyme: early localized, early disseminated and late disseminated. Symptoms can overlap and be different for everyone.

Fact #12 – A reliance on “signs”, rather than “symptoms”, to diagnose Lyme can lead to many missed cases – https://www.columbia-lyme.org/signs-and-symptoms.

Fact #13 – Remember this? Caused quite a stir. However, many people do not realize how small a tick can be so it’s worth sharing again – https://www.prevention.com/health/a27655728/cdc-ticks-poppy-seed-muffin-photo/

Fact #14 – The annually reported confirmed/probable case #’s for Lyme are considerably less than the actual #. How less? We don’t know for sure – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6315539/ & https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-019-7219-x.

Fact #15 – According to Johns Hopkins, the western zone of NS has one of the highest incidence rates of Lyme in North America – https://www.saltwire.com/atlantic-canada/news/western-nova-scotias-rate-of-lyme-disease-among-highest-in-north-america-100665847/.

Facts #16 & #17 – Lyme is not just a rash and flu-like symptoms – Lyme arthritis, Lyme carditis & Neurological Lyme are all possible. Educate & Prevent!

Fact #18 – Due to their size, the fact that the tick can secrete an anesthetic so you don’t feel the bite, & their preferred locations on your body, many people don’t realize they were bitten. Knowledge of symptoms is key.

Fact #19 – There are many things you can do to your property to make it less hospitable for ticks – https://novascotia.ca/dhw/cdpc/documents/Landscape-Management-Handbook.pdf. These should reduce the number, but not totally eliminate, so prevention measures are still key.

Fact #20 – “Lyme disease needs to be treated! If left untreated, the rash and fever will eventually go away, but infection can later spread to joints, the heart, and the nervous system.” – Stamford Health.

Fact #21 – Some people can become chronically ill due to a tick bite. We do not yet know why – https://www.columbia-lyme.org/chronic-symptoms.

Fact #22 – Lyme arthritis can be misdiagnosed as juvenile arthritis – https://www.columbiadoctors.org/childrens-health/pediatric-specialties/rheumatology/treatments-conditions/lyme-arthritis.

Fact #23 – “Untreated Lyme disease during pregnancy can lead to infection of the placenta” (CDC) – https://www.frontiersin.org/articles/10.3389/fmed.2022.816868/full.

Fact #24 – Borrelia burgdorferi can affect your bones – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5278181/.

Fact #25 – Powassan virus can transmit very quickly. Therefore, prevention is key – https://www.columbia-lyme.org/powassan-virus.

Fact #26 – Did you know that the IDSA Lyme Guidelines have a Disclaimer, under the Notes section, advising that following the guidelines is voluntary & not intended to supplant physician judgement. All doctors should make themselves aware of the FULL Disclaimer – https://www.idsociety.org/practice-guideline/lyme-disease/#Notes.

Fact #27 – Tick testing is available in Canada, for a fee – https://geneticks.ca. Although not a diagnostic tool, it can provide beneficial information.

Fact #28 – Ticks can be transmitters of a number of things – https://www.canada.ca/en/public-health/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-issue/2019-45/issue-4-april-4-2019/article-2-increased-risk-tick-borne-diseases-climate-change.html. This list, and no doubt more. Canada needs to do better keeping us up-to-date on what’s here.

Fact #29 – There is a very good, made in Canada, educational resource now available for nurses & other health care providers – https://vbd.casn.ca.

Fact #30 – Many Lyme patients have undertaken considerable research while stuck at home too sick to do anything else. Perhaps Doctors too busy to do research should start listening to them.

Fact #31 – On the last day of #LymeDiseaseAwarenessMonth I want to reiterate that Lyme isn’t rare; hard to get; or always easy to treat; and that it’s not always just a rash and flu-like symptoms. It’s also not just Lyme that can transmit. Prevention & Education are key!