Lyme disease is a bacterial illness spread to humans by ticks. Species of Borrelia are the causative agents. There are many strains of borrelia that cause Lyme disease (borreliosis) in humans just as there are many strains of the flu virus that cause flu symptoms in humans.
Ticks carrying the Lyme disease bacterium have been found across Canada, and within Alberta's provincial borders. In a 2013 surveillance study by Alberta Health, 20 % of collected blacklegged ticks were found to be infected with the Lyme bacteria, Borrelia burgdorferi.
Albertans face a shortage of options for treatment and many spend their days jumping hurdles within the Alberta health system as they seek diagnosis and treatment for this often debilitating disease.
Stage 1: Early infection (first few days after infection)
Stage 2: Infection spreads (days to weeks following infection)
Stage 3: Chronic Lyme (days to weeks after infection if left untreated, or not properly treated, for months/years after infection)
Lyme disease is most treatable during Stage 1. As time passes, both treatment and diagnosis become more difficult. Symptoms worsen during each stage of infection, ranging from flu-like symptoms to neurological illnesses, including paralysis. In chronic Lyme disease, every system of the body can be adversely affected.
The incidence of Lyme disease is on the rise in Alberta and across Canada. It’s crucial to decrease your risk of infection by taking preventative action and learning important information about Lyme disease.
What You Need to Know
1. Lyme disease is transmitted by the bite of an infected tick and the disease has been found in Alberta and across Canada, the U.S. and many countries around the world. A patient's province or country of residence does not accurately reflect his or her Lyme disease risk because people travel, pets travel, and ticks travel. This creates a dynamic situation with many opportunities for exposure to Lyme disease. Ticks know no borders and do not respect boundaries.
2. Fewer than 50% of patients with Lyme disease recall a tick bite.
3. Fewer than 50% of patients with Lyme disease recall any type rash. Although the erythema migrans (EM) is considered definitive of Lyme infection, it is not the most common dermatologic manifestation of early-localized Lyme infection. Atypical forms of this rash are seen far more commonly and can appear in various areas of the body; often not at the bite site.
4. Alberta uses a two-tier screening system to detect Lyme disease. The elisa screening test is the first tier and has been shown to be unreliable. The test misses 35% of culture proven Lyme disease (only 65% sensitivity) and is unacceptable as the first step of a two-step screening protocol. By definition, a screening test should have at least 95% sensitivity.
5. Of patients with acute culture-proven Lyme disease, 20–30% remain seronegative on western blot (secondary confirmatory tier). Antibody titers also appear to decline over time; thus while the western blot may remain positive for months, it may not always be sensitive enough to detect chronic infection with the Lyme spirochete. For “epidemiological purposes” the CDC eliminated from the western blot analysis the reading of bands 31 and 34. These bands are so specific to Borrelia Burgdorferi that they were chosen for vaccine development. Since a vaccine for Lyme disease is currently unavailable, however, a positive 31 or 34 band is highly indicative of Borrelia Burgdorferi exposure. Yet these bands are not reported in commercial Lyme tests.
6. There are 5 subspecies of Borrelia Burgdorferi, over 100 strains in the U.S., and 300 strains worldwide. Canada/Alberta’s testing system looks for one strain – a virtual needle in a haystack.
7. There are no tests currently available to prove that the Lyme organism is eradicated or that the patient with chronic Lyme disease is cured.
8. Like Syphilis in the 19th century, Lyme disease has been called the great imitator and should be considered in the differential diagnosis of rheumatologic and neurologic conditions, as well as Chronic Fatigue Syndrome, MS, Fibromyalgia, Somatization Disorder and any difficult-to-diagnose multi-system illness.
Disclaimer: The foregoing information is for educational & resource purposes only. It is not intended to replace or supersede patient care by a healthcare provider. If an individual suspects the presence of a tick-borne illness, that individual should consult a healthcare provider who is familiar with the diagnosis and treatment of tick-borne diseases.