Lyme Disease

May 8, 2019

By Trevor Shewfelt, Pharmacist at the Dauphin Clinic Pharmacy

"Pick 5 items." "Pick 5 items." "Pick 5 items." "Pick 4 items." This is efficiency in action. Humans just aren't that good at seeing 19 identical items. If you want a dumb human to pick 19 identical items off a shelf and put them into a basket, breaking the task into small steps is key. Humans do have amazing hands that can locate and move items quickly and carefully. Robots aren't really that good at picking individual, fragile items off a shelf. But wait, what if we could combine the knowledge of a super smart computer will the fragile item picking ability of a human? Thankfully, that problem has already been solved. The Jennifer Unit is a headset that tells human workers what to pick from shelves in a warehouse. Since the robot overlord is smart and the humans have dextrous fingers, they make a good team. And since no robots can clean a toilet yet, that seems like another good human job. The future looks bright indeed.

As the weather warms, you might see a walk in nature in your future. If you go for a walk in the long grass or dense brush you can also expect ticks. 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.

When I picture our new robot overlords, I always picture SkyNet and Terminators. I imagine robots that are good at doing things and don't like us much. It turns out, I might be wrong, but not in a good way. Robots bodies aren't that great at doing things yet. Humans bodies are still better than robots at selecting and moving fragile glass bottles off a shelf. Robots can't clean a toilet. And climbing stairs while balancing on two feet is not a simple task for our future overlords. But the software in robots makes them smarter than us. Medical software is better than human doctors at diagnosing and treating some diseases. Legal software is better than human lawyers at some legal tasks. Autopilot software fly planes better than human pilots in some cases. The Jennifer Unit will be just an early interface of humans doing the robot grunt work. I can't wait!

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/publichealth/diseases/lyme.html

Where black legged ticks are in Manitoba: www.gov.mb.ca/health/publichealth/cdc/tickborne/surveillance.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

50 Things that made the modern economy - robots - https://www.bbc.co.uk/programmes/p04tz7rg

Rise of the Robots - BBC - https://www.bbc.com/news/business-39296096

 


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