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Lyme Disease

Lyme disease is an infection transmitted to people through the bite of a black-legged tick infected with the bacterium Borrelia burgdorferi. Lyme disease is a serious illness that may affect the joints, the heart and nervous system resulting in long-term illness. However, if treated early with the appropriate antibiotics, most people with Lyme disease will completely recover.

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1. Risk in Saskatchewan

The risk for Lyme disease is low in Saskatchewan, but not zero.

Most ticks (97 per cent) found in Saskatchewan are the American dog tick. This species is not capable of transmitting Lyme disease to people. Rocky Mountain wood ticks and the winter tick (or moose tick) are also found in Saskatchewan.

Of the 28,643 ticks collected and identified in Saskatchewan since 2008, only 65 were black-legged ticks. Among these 65, only eight black-legged ticks tested positive for the bacterium that causes Lyme disease. Detailed surveillance data.

                                                Black-legged tick

                                                                              Black-legged tick

Black-legged ticks are most often found in southern British Columbia, southeastern and south-central Manitoba, southern, eastern and northwestern Ontario, southern Quebec, southern New Brunswick and Grand Manan Island, and parts of Nova Scotia. Visit the Public Health Agency of Canada’s website for detailed information about risk areas across Canada.

Black-legged ticks are spreading elsewhere in Canada. Established populations of black-legged ticks have not been identified in Saskatchewan; but, infected ticks may be dropped off by migrating birds. People may be exposed to black-legged ticks in wooded areas as well as brushy, overgrown areas between woods and open spaces.

The adults are quite small (about the size of a sesame seed) and the immature stages are even smaller (the size of a freckle or a pin head).

                                                   Black-legged ticks all stages on the dime

         Photo courtesy of Robbin Lindsay, National Microbiology Laboratory, Public Health Agency of Canada

Ticks can transmit the bacteria regardless of what stage they are at in their life cycle. Therefore people should take preventative measures whenever they are outside. You may not know you’ve been bitten, since ticks are very small and their bites are usually painless.

Ticks are most active when the weather warms up in the spring (temperatures higher than 4°C) and remain active until the freeze-up occurs. The greatest risk of getting a tick bite occurs during spring and summer months.

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2. Precautions

Ticks are found in tall grass, brush or wooded areas throughout southern Saskatchewan.

When heading outdoors:

  • Wear pants, long-sleeved shirts and close-toed shoes or boots.
  • Pull socks over your pant legs to prevent ticks from crawling up your legs.
  • Wear light-coloured clothing so ticks can be seen easily.
  • Use insect repellent containing DEET or Icaridin. Apply repellent to exposed skin; always read and follow the directions on the label.
  • When hiking, stay on paths and avoid contact with tall grass and overgrown brush.

When returning from outdoors:

  • Shower or bathe within two hours of being outside to wash off loose ticks.
  • Do ‘full body’ tick checks daily on yourself, your children, and pets. Some ticks are quite small (the size of a pin-head or freckle), so look carefully.
  • To remove ticks from clothing, put your clothes in a hot dryer or hang them out in the sun on a hot day for at least 15 minutes. The heat can kill the ticks. Also check for ticks on any gear you had with you in the woods. 

Tick Removal

If you find a tick attached to your skin:

  • Carefully remove it with fine-tipped tweezers and grasp the mouth of the tick as close to the skin as possible.
  • Pull slowly upward and out with a firm steady pressure.
  • Do not handle the tick with bare hands and be careful not to squeeze, crush or puncture the body after removal as this may also contain infectious fluids.

 

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3. Symptoms, Diagnosis and Treatment

Symptoms

Symptoms of Lyme disease vary and may develop days or weeks after a person is infected from a tick bite. Early symptoms may include:

  • Fever, chills, headache, muscle and joint pain, fatigue or swollen lymph nodes.
  • A rash at the site of the tick bite develops in 70 to 80 per cent of people infected.
  • A distinctive expanding, red ‘bulls-eye’ rash may develop at the site of the bite in some people.
  • Later symptoms may include dizziness, abnormal heartbeat, mental confusion or inability to think clearly (brain fog), nervous system disorders (involving the brain, nerves and spinal cord).

Diagnosis

Getting a diagnosis of Lyme disease can be difficult as your symptoms may be similar to other illnesses. Inform your health care provider of any travel outside of the province and whether you have developed a rash around a recent tick bite. 

Prevention and early diagnosis of Lyme disease are important. Consult a health care provider as soon as possible if you think you may have Lyme disease. The earlier you receive a diagnosis and treatment, the better your chances to make a full recovery.

Your health care provider should:

  • review your symptoms;
  • find out if you were in an area at risk of having Lyme-infected blacklegged ticks;
  • do a physical examination; and
  • order laboratory blood tests to see if you have certain antibodies that could indicate you have the disease.

The Roy Romanow Provincial Laboratory (RRPL) follows testing guidelines set out by the Canadian Public Health Laboratory Network. The testing involves a two-step process that includes an initial screening blood test followed by confirmatory testing at the National Microbiology Laboratory (NML) in Winnipeg. This is considered to be the best diagnostic testing for Lyme disease, and needs to be used in conjunction with clinical information about the patient.

Positive test results from laboratories in the United States or Europe that do not use methods validated by organizations such as the US Centers for Disease Control and Prevention or the International Organization for Standardization, should in general be confirmed through repeat testing through the RRPL. This ensures that Canadians are all diagnosed by laboratory tests according to recognized international standards.

Treatment 

Treatment is most successful in the early stages of the disease and involves a course of antibiotics for two to three weeks. Some people may experience symptoms that last months to years after treatment with a condition known as post-treatment Lyme disease syndrome (PTLDS). Symptoms can include:

  • sleep disturbance;
  • fatigue (tiredness);
  • muscle and joint pain; or
  • mental confusion or inability to think clearly.

Information on Lyme disease is also available on HealthLine Online by typing Lyme Disease in the health topic search.

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4. Submitting Ticks for Testing

You can submit ticks taken from animals to the Western College of Veterinary Medicine at the University of Saskatchewan or, if they are from people, to the Roy Romanow Provincial Laboratory.

Ticks should be placed in a hard container (clean, empty pill bottles work well). Please do not use glass containers. Place moistened tissue paper, paper towel, gauze or cotton in the collection container to protect the specimen and to maintain any ticks that are alive during transport.

Mail the container of a tick taken from an animal with a completed Tick Submission Form (below) to:

Western College of Veterinary Medicine, Department of Veterinary Microbiology
University of Saskatchewan
52 Campus Drive
SASKATOON SK  S7N 5B4

Mail the container of a tick taken from a person and the completed Tick Submission Form to your local public health office or mail to: 

Roy Romanow Provincial Laboratory
5 Research Drive
REGINA SK S4S 0A4

All black-legged ticks will be sent to the National Microbiology Laboratory for testing for Lyme and other tick-borne diseases.

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5. Surveillance data

Ticks, human cases and blood samples tested in Saskatchewan
Source: Public Health Agency of Canada and the Roy Romanow Provincial Laboratory
 Year  Ticks (all species) 
 Black-legged ticks 
Black-legged ticks 
positive for 
Borrelia burgdorferi¹
 
Human cases 
Canada
 
 
Human cases
Saskatchewan

 
 Samples tested
 2008  N/A  5  0  N/A  0  N/A
 2009  1,478
 5  1  144  0  543
 2010  1,139
 3  0  143  0  801
 2011  736
 3  1  266  13 
 599
 2012  2,896
 1  0  338  0  850
 2013  1,726
 10  1  682 13 
 811
 2014  3,176
 5  0  522  0  1,174
 2015  5,103
 9  1  917  0  1,311
 2016  5,300
 9  0  9922  
 13 
 1,428
2017  5,112 
 15
 4  N/A  43
 1,639
 20184  1,977  05  0  N/A  1  1,270
Total  28,643
 65  8  4,0046
 8 10,4266
Notes: 
¹ Borrelia burgdorferi is the agent that causes Lyme disease.
² Based on the Public Health Agency of Canada Lyme disease case definition updated in 2016, includes confirmed and probable cases. 
3 2011 case possibly locally acquired but associated with travel; 2013 and 2016 cases linked to travel outside the province; in 2017, one case acquired locally and three cases linked to travel outside the province; in 2018, one travel-related case. 
4 Figures are to August 31, 2018.
One possible, travel-related black-legged tick in 2018.  
6 Testing increased by 202 per cent from 2009 to 2017.









Black-legged ticks 
positive for 
Borrelia burgdorferi¹
 

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