Lyme disease in PEI

Lyme disease is a bacterial infection transmitted to humans by a bite from an infected blacklegged (deer) tick (Ixodes scaplularis). Ticks attach to the skin and feed on blood. A tick carrying Borrelia burgdorferi bacteria that can cause Lyme disease can transmit the disease after filling itself with blood, which takes at least 24-36 hours.

How can I protect myself from Lyme disease?

There is a risk of encountering ticks in PEI. The following measures should be taken to prevent being bitten by a tick:

• Cover up if there is a possibility of exposure to ticks in the area. Wear closed-toe shoes, long-sleeved shirts and pants with the legs tucked into socks. Wear light-coloured clothing.
• Insect repellents that contain DEET (concentration between 20-30%) or Icaridin are recommended. Repellents can be applied to clothing as well as exposed skin.
• Daily “full body” checks for ticks should be performed. Ticks attach themselves to the skin so finding and removing them early (within 24 hours) prevents infection. Children and pets should be checked for ticks as well.

What should I do if I find a tick attached to me?

Removing ticks within 24-36 hours after the tick bite usually prevents infection, however, you should monitor for symptoms such as fever, fatigue, muscle aches and headaches and/or a rash (particularly a bulls-eye shaped rash). If they occur you should seek medical attention.

Starting in June 2021, a tick found on a person, a pet or the environment can be identified through the eTick.ca platform. This is a free platform where citizens can submit electronic photos of collected ticks. By submitting a photo of a tick, the citizen receives information in less than 48 hours about the name of the species of the tick collected and information on the clinical relevance of the species in question and on how to proceed after a tick bite. Collaboration between citizens and researchers facilitates the monitoring of the arrival of new species, including those that may pose a risk to public health. Further information and step by step instructions can be found here or by downloading the eTick app on the Google Play store or the Apple store.

What is the risk of encountering a tick infected with Lyme disease in PEI?

PEI is considered a low risk area for Lyme disease. Of the ticks that can be found on PEI, only the blacklegged tick (I. scapularis) can carry the Lyme disease causing bacterium, B. burgdorferi. It is possible to encounter a blacklegged tick infected with the Lyme bacteria so it is important to follow prevention measures. 

In 2020 through passive surveillance, there were seventy two (72) tick samples submitted to the PEI lab. Forty nine (49) of these were Ixodes scapularis, and three (3) of these ticks tested positive for Borrelia burgdorferi. Although these ticks were taken from a person while they were in PEI, it is possible some ticks may have been carried to PEI during travel.

In 2019 The Canadian Lyme Disease Research Network (CLyDRN) launched a pan-Canadian sentinel surveillance initiative, the Canadian Lyme Sentinel Network (CaLSeN). The goal was to use standardized methods of performing active tick surveillance across the country to get a complete picture of tick populations in Canada. In the summer of 2019 (May 22-August 20), a systematic drag sampling protocol was performed in various sites across the country. The ticks collected were identified for species and were also tested for tick borne diseases including the bacteria that cause Lyme disease. Five (5) sites with suitable tick habitats were chosen within a 25 mile radius of Charlottetown in PEI. Two of the drag sites produced one tick each. One nymph and one adult were found and neither was carrying a tick borne disease. The complete article can be found online. 

How prevalent is Lyme disease in PEI?

Since 2012, the combined number of probable and lab confirmed cases of Lyme disease in PEI has ranged from 0 to 4 cases per year. PEI’s first case of lab confirmed Lyme disease without travel outside of PEI was diagnosed in 2012, and there has not been a lab confirmed case since that time without recent history of travel to an area of moderate to high risk. In 2020 there was one (1) lab confirmed Lyme case that was travel-related.   

What other diseases can ticks carry?

Along with Lyme disease, I. scapularis (the blacklegged deer tick), can transmit a number of rare diseases, including Anaplasma phagocytophilum (the bacterial causal agent of human granulocytic anaplasmosis), Babesia microti (the protozoan causal agent of human babesiosis) and Powassan encephalitis virus. These bacteria and viruses have been found infrequently in ticks and can be prevented by following the same prevention measures as described above for Lyme disease.

How is Lyme disease treated?

Physicians in Prince Edward Island are required to follow national and provincial guidelines for the antibiotic treatment of Lyme disease. Patients are encouraged to discuss any questions or concerns about Lyme disease with their health care provider. Individuals with ongoing symptoms that have been attributed to Lyme disease based on alternative serologic criteria or clinical criteria alone experience very real and sometimes debilitating symptoms. However, the cause of these symptoms is often not clear. The Association of Medical Microbiology and Infectious Disease Canada does not support the prolonged use of antibiotics for the treatment of Lyme disease; in fact, evidence supports that taking antibiotics long term increases the risk of developing serious bowel infections (such as from C. difficile), allergic reactions, and infections from antibiotic resistant bacteria.

What should I do if I think I have Lyme disease?

If you have been in a grassy or wooded area and have symptoms such as fever, fatigue, muscle aches and headaches and/or a rash (particularly a bulls-eye shaped rash), you should seek medical attention.

What is being done to learn more about Lyme disease?

The Government of Canada is taking a national leadership role in the prevention and control of Lyme disease in Canada. PEI’s Chief Public Health Office is supporting and following the federal government’s National Action Plan on Lyme disease that commits to an evidence-based approach to research and treatment of Lyme disease.  All partners, including provincial and territorial health care regulatory authorities, will be consulted on innovative, evidence-based approaches to address the needs of patients. The Action Plan includes the establishment of a research network on Lyme disease and will be reviewed within five years of its publication. Any updates to the Action Plan can be found on the Canada.ca website.