Ticks the Season!

You probably know by now that there is no longer a tick season in Nova Scotia, and many other areas, due to the fact that we can have tick friendly temperatures any month of the year. Therefore, you need to give ticks a thought all year if outdoors in tick habitats, or really just about anywhere.

Although they prefer shady, moist areas, there is still a chance of coming upon them in areas where you would least expect them. They can fall off a host anywhere. Migratory birds transport ticks all over the place. This means ticks can drop off birds in your yard, a park, or anywhere the birds stop to feed, or fly over.

The fact that migratory birds can bring ticks from many areas also results in the possibility of ticks carrying many things as they come from areas with different tick-borne diseases. They can also bring different types of ticks. Two services that are available in Canada to provide more information is eTick – https://www.etick.ca/ and Geneticks – https://www.geneticks.ca/about-geneticks/. One is for determining what type of tick it is and how long it may have been attached and the other is for testing a tick that was attached. Although there is a fee for tick testing, I highly recommend testing for common infections if it was attached and engorged. Although this is not a diagnostic tool, it can provide valuable information to you if symptoms arise.

At one time, not that long ago, ticks were not expected to be active until May. Therefore, May is generally known as Lyme Disease Awareness Month around the world. Since 2016, however, the Canadian Veterinary Medical Association (CVMA) has made March “National Tick Awareness Month” – https://www.canadianveterinarians.net/about-cvma/latest-news/the-2023-national-tick-awareness-month-campaign-reminds-us-that-we-have-all-the-tools-we-need-to-outsmart-ticks/. They have a great website full of information – https://ticktalkcanada.com/.

It is generally accepted that our pets can be sentinels of disease – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6313866/. There needs to be more information available to the general public as to what veterinarians are seeing in dogs as that can give a good indication of what is present in different areas and at what rate. If ticks are biting our pets, there is a good chance that they could be biting us.

Many veterinary hospitals now post fairly regularly regarding ticks and tick-borne diseases – https://petfocus.ca/bedford-south/tick-trouble/. They usually have accurate, up-to-date, information, with many veterinarians now recommending year-round tick treatment.

Information is now ramping up about ticks and tick-borne diseases. However, some information can be outdated, and some can be wrong. Therefore, always check what you read and don’t share unless you know it’s accurate – especially regarding how to properly remove a tick. The federal government has a helpful video in this regard – https://www.canada.ca/en/public-health/services/video/lyme-disease-properly-remove-tick.html.

Although our dogs have tick treatments, a Lyme vaccine, and quick tick-borne disease tests, humans are not so lucky so prevention is key. We take good care of our pets but need to take better care of ourselves.

Tick & Tick-borne Disease Facts for Lyme Disease Awareness Month

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!