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Thiel: Understanding Lyme disease
I have had many patients this week ask me about ticks and Lyme disease.
The Public Health Agency of Canada is currently doing surveillance of Lyme disease in Canada as recent studies demonstrate the risk of this disease is growing in our country.
Lyme disease is an illness that is contracted by contact with a bacterium known as borrelia burgdorferi.
This disease, spread by the bite of certain types of ticks, is the most common vector borne disease throughout North America.
This is how the disease cycle starts. Ticks that live in wooded areas get infected when they feed on small rodents and birds that carry the bacterium.
Ticks then spread the bacteria to humans via their bite. Most often, tick bites happen unknowingly, as they are usually painless.
In Kelowna, the western blacklegged tick is the insect that is responsible for carrying Lyme disease.
Ticks are classified as an arachnid that feeds on blood. They are normally about 3 to 5 mm in length, but can be smaller and red or dark brown in colour. It is estimated that 10 per cent of all ticks carry Lyme disease.
The first sign of Lyme disease, secondary to a tick bite is a perfectly circular rash that is usually at least five centimetres in diameter.
This begins about three days after the initial bite and can persist up to eight weeks. With this rash, skin irritation, itchiness, pain and swelling are not usually common.
Systemically, the individual may suffer from headache, muscle and joint pain, fever and chills, and swollen lymph nodes.
If untreated, symptoms may continue on to central and peripheral nervous system dysfunction, arthritis and arthritic symptoms, extreme fatigue and multiple skin rashes.
The most important part of the diagnosis is that it needs to take place early in the process.
Most clinicians recognize the typical bull’s-eye appearance to the rash, however, this is the less common variant.
Normally the rash is uniformly red with no bull’s-eye presentation. In fact, only 20 per cent of these bites present as a bull’s-eye appearance. While viral illnesses and other bacterial infections can cause symptoms of fever, fatigue and pain that mimic Lyme disease, they do not have large distinct round or oval rashes like Lyme disease.
In addition, most viral illnesses have typical cold symptoms of runny nose or prominent cough which are not common in Lyme disease.
Lyme disease is successfully diagnosed by the doctors assessment, evidence and history of encounters with ticks and laboratory testing. Although, there is controversy as to whether or not health Canada is testing appropriately for Lyme disease and many individuals are having their testing done in the United States for confirmation and subsequent treatment of Lyme disease. Treatment currently consists of about two to four weeks of antibiotic treatment.
However patients who are diagnosed in the later stages of the disease have persistent and recurrent symptoms. These individuals are known to have something called post-Lyme disease syndrome.
The current research indicates that the mainstream medical community is divided as to the prevalence and the presence of Lyme disease in Canada.
Prevention is always the best medicine. During the spring months, when ticks are most prevalent, be mindful when walking in wooded or grassy areas that these ticks may coexist.
Wearing pants and long-sleeved shirts in addition to closed shoes as opposed to sandals offers a barrier that is usually sufficient.
It may sound a little paranoid, but my wife and I routinely check the kids when they come in from playing outside by doing a careful inspection of the exposed areas and their hair.
Three friends of ours have taken ticks off of their children in the last week. If you do come across a tick that has embedded itself in the skin, carefully remove the tick using tweezers. Be sure to grasp the ticks heads and mouth as close to the skin as possible and pull slowly.
Do not twist or rotate or squash the tick in an attempt to remove it.
Wash the bites with soap and water and disinfect with alcohol. Keep the tick for a number of weeks and observe for the presence of a rash. Contact your doctor immediately if you see any symptoms whatsoever.
I am by no means endorsing the fact that we should all put on our Hazmat suits for our next walk through the forest, as the prevalence of this disease is still quite low.
However, it is important to be aware of it as its consequences can be devastating if left undetected and not diagnosed in time.