Lyme Disease

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

Most ticks (about 96 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.

Between 2008 and 2020, 33,970 ticks were collected and identified in Saskatchewan, and only 90 were blacklegged ticks. Of these 90, only 13 blacklegged ticks tested positive for the bacterium that causes Lyme disease.

Detailed surveillance data.

Blacklegged tick

Blacklegged 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.

Blacklegged ticks are spreading elsewhere in Canada. Established populations of blacklegged ticks have not been identified in Saskatchewan but infected ticks may be dropped off by migrating birds. People may be exposed to blacklegged 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 pinhead).

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. You may not know you have been bitten, since ticks are very small and their bites are usually painless. See below for precautions to take to prevent tick bites.

Ticks are active when the weather warms up (temperatures higher than 4°C) and remain active until freeze-up occurs. Since adult blacklegged ticks are active in the spring and fall months, and nymphs are found in the late spring and summer, the risk of being bitten by a tick can exist for the entire spring, summer and fall period.

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 as soon as possible after being outside to wash off loose ticks.
• Do 'full body' tick checks as soon as possible after being outside on yourself, your children, and your pets. Some ticks are quite small (the size of a pinhead 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.

Video Credit: Kateryn Rochon, University of Manitoba Entomology Department
Posted with permission of the University of Manitoba

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.

As of April 1, 2020, you can submit photographs of ticks for identification on the web-based platform, eTick, by following these steps:

1. Take a photograph of the tick using your smart phone or digital camera
2. Submit the photograph using the eTick online system

Researchers at the University of Saskatchewan will use these photographs to identify the tick species.

Following confirmation of the species, you will receive timely public health information about your risk of exposure to tick-borne diseases.

Please keep your tick in a secure container. Researchers may ask you to submit ticks, by mail, for quality control purposes or if the tick species is one of medical concern. Mail-in tick submissions, unless requested by eTick administrators, will no longer be accepted.

Ticks, human cases and blood samples tested in Saskatchewan

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; 2019 case acquired in the U.S.A.; 2020 case possibly acquired in SK, AB or BC.
⁴ Testing increased by 179 per cent from 2009 to 2019.
⁵ Of the 12 blacklegged ticks, 7 physical specimens were submitted for Borrelia burgdoferi testing.