Lyme Disease

Lyme disease is an important health concern in many parts of Canada and is spread by the bite of blacklegged ticks infected with the bacterium Borrelia burgdorferi. Most people are infected with Lyme disease through the bite of an immature tick called a nymph.

Nymphs are tiny (less than two mm, about the size of a poppy seed) and difficult to see. Nymphs feed during the spring and summer months. Adult ticks are much larger and are more likely to be discovered and removed before they have had time to transmit the bacteria. Adult blacklegged ticks are most active during spring and again in late summer and fall.

The blacklegged tick that carries the bacteria that can cause Lyme disease is present in the Ottawa area, across Eastern Ontario, and the Outaouais region of Quebec.

Ottawa Public Health has seen an increase in the number of cases of Lyme disease reported in the Ottawa area over time, as well as an increase in the number of cases of Lyme disease likely acquired in the Ottawa area. This is most likely a result of growing Lyme disease awareness and increase in tick populations in Eastern Ontario.

Ottawa Public Health is committed to reducing the health risks to residents posed by Lyme disease through prevention, education and awareness, as well as surveillance. Preventing tick bites is key to the prevention of Lyme disease.

Populations of blacklegged ticks are growing and expanding into new areas as the climate warms. This means that the risk of contracting Lyme disease is on the rise across Canada. Though blacklegged ticks can be found almost anywhere outdoors, they are most often found in habitats that maintain ground-level moisture and humidity such as in tall grasses, and bushy/shrubby, wooded and forested areas.

Ottawa Public Health recommends practicing these simple steps to help minimize exposure to blacklegged ticks, and help you enjoy the outdoors safely:

• Apply a Health Canada approved insect repellent containing DEET or icaridin to exposed skin and clothing
• Wear long pants, a long-sleeved shirt, shoes, and socks to cover exposed skin
• Tuck your pants into your socks
• Wear light-coloured clothing to spot ticks more easily
• If possible, stay on the trails when hiking in the woods and other natural areas. Enjoy the mowed and maintained areas of parks and playing fields but be mindful of the borders adjacent to natural areas that may be suitable tick habitat.
• Do a "full body" check on yourself, your children, and pets for ticks. Pay careful attention around your toes, knees, groin, armpits and scalp.

Blacklegged ticks are very small and not easy to see, nymphs are the size of poppy seeds and adults are the size of sesame seeds, which is why you should perform a full body check on yourself, your children and your pets after being outdoors. The sooner ticks are removed from the body the less likely they are to spread Lyme disease.

You can't guarantee to be rid of ticks completely, but you can reduce the risk of ticks in your yard. Here are some tips to help make your environment less favourable to ticks by:

• Keeping the grass in your yard mowed
• Adding a wood chip, gravel, or river-stone border, one or more metres wide, to separate forested, shrubby, or tall grassed areas from your lawn
• Removing brush and fallen leaves from the edges of your property, especially if your yard is bordered by woods or fields of tall grasses
• Cleaning up areas under and around bird feeders to reduce the attraction of small critters such as mice and voles that carry ticks
• Discouraging deer from entering your yard, as ticks also feed on these animals
• Keeping your woodpile neat, dry, off the ground, and away from your house

If you find a tick on your body, remove it as soon as possible. The risk of getting Lyme disease increases with the length of time the tick remains attached.

Since Ottawa is considered an at-risk area for Lyme disease, it is important to contact your doctor or health care provider if you believe a tick has been attached to you for 24 or more hours, or if you are unsure how long the tick has been attached to you, so that your doctor or health care provider can determine if you need treatment with antibiotics. Treatment with antibiotics would be considered when:

• the tick has been attached for 24 or more hours or is fully or partially engorged and
• it has been less than or equal to 72 hours since the tick has been removed.

Your doctor or health care provider will advise you about what should be done straight away. Immediate actions include watching for symptoms of Lyme disease for the next 32 days and, if appropriate, taking a single dose of antibiotics prophylactically.

If the tick was attached for less than 24 hours and its body does not appear swollen from feeding or if you removed a tick and more than 72 hours have passed, you should still be on the lookout for signs and symptoms of Lyme disease for the next 32 days. If you do develop symptoms, consult your doctor or health care provider.

As of January 11, 2023, your local pharmacist can treat and prescribe medications for tick exposures. Visit the Government of Ontario News Release webpage.

• Use fine-pointed tweezers.
• Grasp the tick's head as close to the skin as possible and pull slowly until the tick is removed.
• Do not twist or rotate the tick. Do not use a match, lotion or anything else on the tick.
• Wash the bite site with soap and water.
• If you are going to see your doctor or health care provider and want to bring the tick with you, place the tick in an empty pill vial or zip-lock bag with a moistened paper towel. For help with identifying a tick, submit a picture through “eTick” (www.etick.ca), an electronic tick identification platform.
• You can dispose of a live tick by flushing it down the toilet, or placing it in a sealed bag/container and disposing it with your household garbage.

How to properly remove a tick

Early and accurate diagnosis and treatment of Lyme disease is key to avoid more serious illness and the potential for long-term complications. Long-term complications can involve muscle and joint pain, irregular heartbeat, and nervous system disorders (involving the brain, nerves and spinal cord).

• Circular, red rash (may look like a 'bull's-eye', but the appearance of the rash may vary), which slowly expands around the tick bite area. In 2 or 3 out of 10 people no rash is found.
• Fatigue (tiredness)
• Fever or chills
• Headache
• Muscle and joint aches
• Swollen lymph nodes
• Numbness or tingling
• Spasms or weakness

If you develop symptoms of Lyme disease, consult your doctor or health care provider.

If your pet spends lots of time outdoors, a tick check should be part of your daily routine. While dogs and cats cannot directly transmit Lyme disease to people, a tick may enter your home on your pet's back and move on to bite a human.

To help reduce the chances of your pet carrying a tick that may transmit Lyme disease:

• Talk to your veterinarian about ways to protect your pet from ticks. There are many topical products that can help repel or kill ticks, and for dogs there is a vaccine.
• Check your pet daily for ticks, especially if it spends time in wooded or overgrown areas
• Remove any ticks right away and dispose
  • Use fine-pointed tweezers.
  • Grasp the tick's head as close to the skin as possible and pull slowly until the tick is removed. Do not twist or rotate the tick. Do not use a match, lotion or anything else on the tick.
  • Wash the bite site with soap and water.
  • Dispose of a live tick by flushing it down the toilet, or placing it in a sealed bag/container and disposing it with your household garbage.
  • When your pet is examined by a veterinarian, ask for a thorough tick check.

Unfortunately, a Lyme disease vaccine is not available in Canada.