After a long, cold winter, the nice weather has finally arrived. It’s time to get outside to enjoy the great outdoors. As you’re planning your checklist of necessities for a good and safe season ( sunscreen, sunglasses, water), don’t forget tick repellant. Tick repellant? Why? Unfortunately, the answer is Lyme Disease. The disease that we’ve been told does not really exist in eastern Ontario is definitely here. In our pharmacy, we’ve seen a big increase in Lyme patients and this disease can carry with it some devastating long term consequences.
My colleague and I recently attended the VOCAL (Voices of Canadians About Lyme) conference here in Ottawa. Along with hundreds in attendance, we heard the heart wrenching stories of many Lyme patients. Theirs are stories of frustration, about how misunderstood this disease is. People are often told that Lyme doesn’t exist in eastern Ontario and that their symptoms are in their heads. The typical tests offered to diagnose Lyme are not accurate. There is still a widespread belief that chronic Lyme doesn’t exist. It is terribly under-funded (especially in comparison with other vector borne diseases like Zika or West Nile viruses). It’s time that Canadians and the medical community get up to speed on Lyme.
Lyme Disease is a bacterial infection caused by a spirochete of the Borrelia burgdorferi family. It is spread by ticks who have been infected by the bacteria. Ticks cannot fly or jump. They wait for a host to grab onto in grass, shrubs and leaves. They can attach to any part of the human body, but like to hide in areas like armpits, the groin or scalp. Once attached they will slowly suck its host’s blood for several day, and when done, drop off. When ticks are in the nymph phase, they are very small and hard to detect on skin, making it more likely to be infected. Once ticks are in the adult phase of their life cycle, they are larger and easier to see and remove.
Early symptoms of infection can include fever, fatigue, headache, muscle aches, stiff neck, sore joints, blurry vision, swollen lymph nodes and possibly a rash. Not everyone gets the tell-tale bulls eye- rash. In fact, it’s estimated that only 25% or less of patients infected will get that rash, and children rarely get it. Most people don’t remember ever having been bitten at all . Lyme disease is more treatable in the early stage of infection. If left untreated, it may become dormant and then active again weeks, months or years later. This is called chronic Lyme. It can infect many systems in the body. It can cause long term effects on the neurological, muscular, respiratory, digestive and cardiac systems. Co-infections are common, making it difficult to treat.
Diagnosing Lyme Disease should be done based on symptoms. You do not need to have all of the symptoms I’ve listed. The important thing to look for is consistency and recurrance of symptoms. If you’ve been bitten by a tick, or think you may have Lyme symptoms, the tests that you’ll most likely be offered are the ELISA test or the Western Blot which are not reliable. They are not direct tests showing the Lyme bacteria . They detect antibodies that your immune system is deemed to make to the bacteria causing Lyme. The problem is that it may take weeks or longer for your body to make those antibodies, resulting in a potentially false negative test. Find yourself a Lyme literate doctor or naturopathic doctor who will diagnose you based on your symptoms, and who will use more accurate tests.
Awareness and prevention are key. Here are some tips on how to keep you and your family safe from Lyme.
- avoid wooded and brushy areas, or areas with tall grass
- wear long pants and long sleeved shirts. Remember that ticks will climb on clothing until they reach exposed skin. Tucking pants into long socks is advised.
- wear light coloured clothing since it’s easier to spot ticks
- walk on pathways. Don’t venture into low-lying brush or long grass
- apply insect repellant to skin , especially at the openings of clothing around the ankle, wrist and neck.
-Do a tick check! Check your body after coming inside. Check between toes, behind knees, back of legs, armpits, belly button, nape of neck, and in hair. Check your pets since they can carry infected ticks indoors.
-Ticks can survive in your wash load, so put clothes in hot dryer for 1/2 - 1 hour to kill them.
If you find a tick on your body, remove it as soon as possible using fine-tipped tweezers. Grasp the tick as close to your body as possible and pull upward. Do not twist it off as this may leave mouth parts embedded in your skin.
There is some debate about which repellants work best. Although DEET repellants are very effective in repelling mosquitos , they are inferior to icaridin based repellants for preventing tick bites. Icaridin (also called picaridin) is odourless , non-greasy and non-toxic. Products containing up to 20% icaridin are considered to be safe and effective. It is available at various retailers. Lyme prevention advocates also recommend spraying clothing and footwear with permethrin 0.5% spray. Permethrin is an insecticide derived from a chemical found in chrysanthemums. It’s used on clothing only. At this time, it’s not available in Canada. Our pharmacy is looking into compounding this product for retail purchase.
This spring, get yourself educated on Lyme Disease and prevention. Spread the word among your family, friends and co-workers. The strong desire of the Lyme patients at the VOCAL Conference was to make sure that no one goes through what they’re going through. It’s a daily battle for so many of them. This is a preventable disease if we’re all educated on prevention and early treatment.
Wrriten by Grace Meehan, Pharmacist and NAMS Certified Menopause Practitioner.