Lyme Disease

Apr 11, 2017

By Trevor Shewfelt, Pharmacist at the Dauphin Clinic Pharmacy

The light was low as I entered the kitchen. There was a palm sized aluminum disc on the counter. It was slightly concaved. It had intricate patterns stamped into it. It's original purpose became clear when I turned it over. It was the top off a pop can. The thing that amazed, then slightly horrified, me was the tab hadn't been lifted. Whoever removed the top off this pop can had done it while the pop can was full. I started looking around the kitchen for some unholy sticky mess on the walls.

There are lots of sticky things around us in the world of creepy crawlies. For example, ticks stick to people very nicely. In Dauphin if you mention ticks, someone will immediately say, "Lyme disease." Lyme disease is a bacterial infection caused by the bacterium Borrelia burgdorferi. The bacterial infection is spread to humans through the bite of a tick. It is believed that a few different species of ticks can spread Lyme disease, but the most likely culprit is the blacklegged or deer tick. The blacklegged tick bites a mouse or deer and picks up the Lyme disease bacteria. Then the blacklegged ticks can bite a human, spread the bacteria and give the human Lyme disease.

What are the symptoms of Lyme disease? Up to 80% of people will develop a rash three to 30 days after a bite from an infected tick. This rash, known as Erythema migrans (EM), is a red expanding skin rash usually more than five cm in diameter. It is not tender or itchy and usually occurs at the site of the tick bite. Often the centre clears and it looks like a bull's eye. Other symptoms of Lyme disease are tiredness, fever, headache, stiffness, muscle aches, and joint pain. People who do not get treated for Lyme disease may go on to have symptoms such as joint pain and swelling weeks to months later. Lyme disease can also affect the heart or nervous system.

Although Lyme disease may have been around for a long time, it has only been described in the scientific literature fairly recently. In the early 20th century, erythema migrans and Bannwarth's syndrome, which are now known to be the skin and nerve problems of Lyme disease, were written about in Europe. Lyme disease was first written about in North America in 1977 and it was called "Lyme arthritis". Apparently it was named after Lyme, Connecticut, the town where the first cases were noticed. It wasn't until 1982 when the bacteria that causes Lyme disease was discovered. In the early 1980's Lyme disease cases started to be reported in Point Pelee, ON which is the farthest south you can go in Canada. Now Lyme disease has been reported from Nova Scotia through Saskatchewan.

It is important to remember that not all ticks in Manitoba carry Lyme disease. Most ticks you run into will be wood ticks which are otherwise known as dog ticks. The blacklegged tick which can spread Lyme disease is quite a bit smaller that the wood tick that most of us are familiar with. The male blacklegged tick is black and kind of looks like a black sesame seed. Females are a little larger than males. The females are approximately 3-5 mm in length. They are brown and black, with black legs. Ticks feed on blood by attaching to animals or people with their mouth parts. Adult blacklegged ticks are most active in the spring and fall. They come out as soon as the snow melts and remain active until the first permanent snowfall or when air temperatures are consistently below 4ºC. Not all blacklegged ticks have the Lyme disease bacteria on them. So, just because a blacklegged tick bites you, doesn't mean you will get Lyme disease. Finally, tests on lab animals have shown that an infected blacklegged tick must be attached to a lab animal for 24 to 36 hours to pass on the Lyme disease bacteria. We assume that a blacklegged tick must be attached to a human for 24 to 36 hours to pass on Lyme disease as well.

How do you avoid getting Lyme disease? First avoid getting bitten by ticks. If you go for a walk anywhere with vegetation, wear long pants and closed toe shoes. Tuck your shirt into your pants and your pants into your socks, and use bug spray with DEET in it. To prevent tick bites, remember to spray from your knees down. Once you come inside, take a shower within two hours. Put your clothes in a hot dryer for one hour to kill any ticks you may have picked up. Check your skin for ticks each day. Check your kids and pets for ticks every day. Remember, Lyme disease isn't likely to develop if a tick is removed within 24 hours, and possibly up to 36 hours, after it attaches. If a tick is attached to you, remove it carefully with sharp, pointy tweezers. Grab the tick by the head a slowly and firmly pull straight out. Grasp the tick firmly and as close to the skin as you can. Slowly pull the tick away from the skin without twisting. Clean the area with an antiseptic. Do not use petroleum jelly, a hot match, or nail polish to remove a tick. CanLyme has some nice tick removal videos on their site. Clean the skin around the tick bite with soap and water. Mark the date and location on the body of the tick bite on the calendar for future reference. If a tick is attached to you for more than 24 hours or you get the bull's eye rash, see your doctor. Lyme disease is treated by common antibiotics like doxycycline.

After awhile I found out it was Eric who had removed the pop can tops. When I asked him why, he said it was so he make root beer ice cream floats without having to do dishes afterward. The worst part of this story was that it left me nothing to yell at Eric about. I couldn't find any root beer spray on the walls of the kitchen. He actually turned the cans into very nice little cups with no sharp edges to cut his mouth. He had opened the pop can with a can opener. About the only thing he did wrong was not put the can and lid into recycling. But if he had done that, I wouldn't have seen his rather elegant solution to a problem I didn't know existed. How to get a root beer float without having to spend 15 extra seconds putting the dirty glass in the dishwasher.

We now have this and most other articles published in the Parkland Shopper on our Website. Please visit us at www.dcp.ca

The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.

Manitoba Health Lyme disease info: www.gov.mb.ca/health/lyme/

Where black legged ticks are in Manitoba: www.gov.mb.ca/health/lyme/surveillance.html

How to identify black legged ticks: www.gov.mb.ca/health/lyme/blacklegged.html

Canadian Lyme Disease Foundation: www.canlyme.com/

CDC tick borne diseases: www.cdc.gov/lyme/resources/TickborneDiseases.pdf

Tick identification: www.tickencounter.org/tick_identification/deer_tick

The Clinical Assessment, Treatment, and Prevention of Lyme Disease, Human Granulocytic Anaplasmosis,

and Babesiosis: Clinical Practice Guidelines by the Infectious Diseases Society of America (including how long has tick been attached by size of tick estimator) : http://cid.oxfordjournals.org/content/43/9/1089.full.pdf+html

CBC Tick Story - http://www.cbc.ca/news/canada/manitoba/blacklegged-ticks-manitoba-1.4054020

 


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