Lyme Disease

Jul 2, 2013

By Trevor Shewfelt, Pharmacist at the Dauphin Clinic Pharmacy


Deer suck. I heard on the news about a woman being attacked by a deer in Kenora, ON. If you heard the story, you probably laughed. Thats because people in the Parkland have the good sense to shoot and eat deer. In my home town of Pinawa, which is near the Ontario border, people feed the deer. People feeding deer has turned the deer into a problem. Pinawa is lousy with deer. Pinawa is infested with deer. It is not unusual to see half a dozen deer sleeping on a persons lawn. And the Pinawa deer arent scared of people or dogs. They eat groceries out of the back of peoples mini-vans while the vans are being unloaded. They attack and injure dogs. And they destroy gardens. In Pinawa you cant have a garden if your yard doesnt have a 10 foot fence around it. Id like to blame the deer for a contagion like Lyme disease, but that is a bit of a stretch.

Lyme disease has been a popular topic in the pharmacy lately. A couple weeks ago, a gentleman came into the pharmacy and asked if there were any confirmed cases of Lyme disease in Manitoba. I didnt know, so I checked with Manitoba Health. They reported that there were 28 human cases of confirmed and probable cases of Lyme disease in Manitoba between 2009 and 2012.

What is 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. See, the deer arent blameless. Then the blacklegged ticks can bite a human, spread the bacteria and give the human Lyme disease.


What are the symptoms of Lyme disease? Many 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 bulls eye. It is disputed what percentage of people who get a tick bite get the bulls eye rash. The Public Health Agency of Canada says 70 to 80 per cent of people who get bit will get the rash. CanLyme or the Canadian Lyme Disease foundation, which is an advocacy group for people with Lyme disease claim less than 50% of people who get bit will get the rash. I think the take home message is that you can get bit and not get a rash.


Other early symptoms of Lyme disease are: a rash other than EM, headache, fatigue, chills, fever, muscle aches, joint pain or swollen lymph nodes. People with an untreated Lyme disease infection may continue to experience symptoms for months or years, including headaches, dizziness, difficulty concentrating, stiff neck, irregular heartbeat, or joint pain and swelling.


Although Lyme disease may have been around for a long time, it has only been described scientifically fairly recently. In the early 20th century, erythema migrans and Bannwarths 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 wasnt until 1982 when the bacteria that causes Lyme disease was discovered. In the early 1980s 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. Before feeding, adult females are approximately 3-5 mm in length and red and dark brown in colour. Ticks feed on blood by attaching to animals or people with their mouth parts. Females are a little larger than males. Blacklegged ticks really arent that common in Manitoba yet. They seem to be slowly spreading in from the South East corner of the province. We believe they are spread by migrating birds. The Manitoba Government has a Blacklegged Tick Surveillance Program. Blacklegged ticks have been submitted from many locations in southern Manitoba and occasionally from more northern areas. Tick submissions range from about 150 to 300 blacklegged ticks per year. Adult blacklegged ticks are most active in the spring and fall. They remain active until the first permanent snowfall or when air temperatures are consistently below 4C. Not all blacklegged ticks have the Lyme disease bacteria on them. So, just because a blacklegged tick bites you, doesnt 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 hours to pass on the Lyme disease bacteria. We assume that a blacklegged tick must be attached to a human for 24 hours to pass on Lyme disease as well.

So how do you avoid getting Lyme disease? First avoid getting bitten by ticks. If you go for a walk in the bush wear long pants and a long-sleeved shirts so most of your skin is covered. Tuck your shirt into your pants and your pants into your socks, and use bug spray with DEET in it that says for use against ticks on the product label. After being in the bush or tall grass, inspect yourself for ticks. It is even better if someone helps you look at places like the backs of your knees which are hard to see on your own. 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. 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 bulls eye rash, see your doctor. Lyme disease is treated by common antibiotics like doxycycline.

Im not a hunter. My dad was, but I never got into it. I do like deer sausage, though. And hunting is the obvious answer to an urban deer problem. The Ontario MinistryS of Natural Resources officer I heard on the news said a fall bow hunt of the deer in Kenora was planned. Maybe when they are done, the Kenora bow hunters can jump on a bus and go 2 hours west to Pinawa. We need someone to clean up the mean, deer infested streets of this little town in the Whiteshell.

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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:

Where black legged ticks are in Manitoba:

How to identify black legged ticks:

Canadian Lyme Disease Foundation:

Deer attacks woman in Kenora :


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