INFECTIOUS DISEASES

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Lyme Disease

Lyme disease is the most common vector-borne disease in Canada. In Ontario, Lyme disease is caused by the bacterium Borrelia burgdorferi, transmitted to humans through the bite of an infected blacklegged tick (Ixodes scapularis). Lyme disease is designated as a disease of public health significance and is reportable under the Ontario Health Protection and Promotion Act.

Prevention, early detection and treatment are essential to reduce the burden of Lyme disease. Health providers should be familiar with:

The local epidemiology and expanding risks of Lyme disease
Signs and symptoms of Lyme disease
Clinical management practices including treatment, laboratory testing and patient education
Reporting requirements

Effective September 20, 2021, The National Microbiology Laboratory (NML) will not accept blacklegged ticks for bacterial testing of Borrelia burgdorferi, as part of the passive tick surveillance program. Passive tick surveillance will be supported by citizen science initiatives, such as eTick.ca, which utilizes digital image-based identification. Health care providers can submit a specimen for tick species identification through either eTick.ca, for quick and accurate tick species identification or the Public Health Ontario Laboratory. To reduce duplication of services, only submit the tick once to one authority. The public health Ontario laboratory will not forward blacklegged ticks to the NML for laboratory testing. Laboratory testing of the specimen should not be used to diagnose Lyme disease in humans.

The incidence of Lyme disease reported in Simcoe Muskoka and Ontario has increased in recent years. The rise is attributable to climate change and other anthropogenic environmental changes driving rapid geographic expansion of blacklegged ticks and supporting conditions suitable for B.burgdorferi. Blacklegged ticks infected with the pathogen causing Lyme disease are known to be present in Simcoe Muskoka and neighbouring areas.

Geography:

Ontario Blacklegged Tick Established Risk Areas 2024 (Public Health Ontario)

Burden:

Simcoe Muskoka HealthSTATS: Lyme Disease and Passive Tick Surveillance (Local)
Public Health Ontario (Provincial)
National Surveillance (National)

Tick Removal
Health Quality Ontario Algorithm (2023)
Early Lyme Disease Management in Primary Care (Centre for Effective Practice)
For Health Professionals: Lyme Disease (Public Health Agency of Canada)
2020 Guidelines for the Prevention, Diagnosis and Treatment of Lyme Disease (Infectious Diseases Society of America) [updated November 2020]
Lyme Disease Serology Collection (Public Health Ontario)
PHO Lab Webinar on New Lyme Serology Testing

Lyme disease is designated as a disease of public health significance and is reportable under the Ontario Health Protection and Promotion Act. Report suspect and confirmed cases within one business day to the local Health Unit.

Disease of Public Health Significance Reporting Form

Avoiding tick-bites, early detection and removal of ticks can significantly decrease the risk of Lyme disease. Clinical management should include patient education on these items. The following resources can be shared:

Lyme Disease and Ticks (Simcoe Muskoka District Health Unit)
How to prevent tick bites when outdoors: Factsheet (Ontario Ministry of Health)
Prevention of Lyme Disease (Public Health Agency of Canada)
Ticks and Early Lyme Disease: Information for Patients (Centre for Effective Practice)

SMDHU encourages the public to use eTick and to contact their health care provider if the tick has been identified as a blacklegged tick. eTick.ca is a public image-based tick identification platform that can quickly and accurately identify tick species.