Lyme Disease: Presentation to TDSB Health and Well-being Committee Howard Shapiro Associate Medical Officer of Health & Director Healthy Environments hshapir@toronto.ca May 31, 2016
Overview Lyme Disease Tick Vector Lyme Disease Statistics Toronto Public Health Program Final Thoughts
Caused by infection with a bacteria What is Lyme Disease Caused by infection with a bacteria Borrelia burgdorferi Transmitted by a particular species of ticks in Ontario Blacklegged ticks (Ixodes scapularis) Important implications Not spread person to person Can prevent by preventing tick bites Treatable with antibiotics – especially early in disease
Lyme Disease – Early (days-weeks) Symptoms Headache, tiredness, muscle and joint aches and pains, fever (sometimes) Red rash at site of bite (Erythma migrans) Treatment Oral antibiotics for 2-3 weeks High effective
Lyme Disease – Late (weeks-years) Symptoms Joints - arthritis (knee and other large joints very common) Heart – palpitations or irregular beat Nervous system – drooping face, inflammation of brain and spinal cord, pains/numbness/tingling in hands and feet; fatigue/difficulty thinking Treatment Antibiotics – oral or IV for 2 weeks to 1 month Less effective than for early Symptoms may persist despite treatment more likely the longer the time until treatment
BL Tick Habitat
Blacklegged tick Life stages and size R. Lindsay PHAC
How big is that tick?
Tick Attachment
Ixodes Tick Life Cycle
Questing tick
Risk of Lyme Disease Increases with Time Tick Attached
Opportunity for Prevention
Human Lyme Disease in Toronto: Cases & Incidence Rate 2004-2014
Ontario Lyme Cases by Month - 2013
Toronto Public Health Lyme Program Surveillance (monitoring) Human Tick (tick populations in Toronto) Passive people bring in ticks for submission to Lab Identified and tested for Lyme bacteria Active Go to likely locations and search for ticks (ID & testing) Education Information for public and physicians through a number of means Fact sheet for schools Taking preventive measures requires a lot of effort so people will not do these unless it is worthwhile. Knowing about tick populations in addition to human surveillance can help inform this effort.
Tick Dragging
Final Thoughts Risk of Lyme disease in Toronto possible but very low (but may be changing) Child with Lyme disease cannot give it to someone else Child with attached tick should have removed promptly (parent, physician)
Typical school yard -lawns, sport fields not tick habitat Final Thoughts Be aware of tick locations & habitats in and outside of City especially for outdoor activities Typical school yard -lawns, sport fields not tick habitat Can prevent ticks and Lyme Staying in centre of trails Clothing and DEET Tick checks, tick removal and showering after being in tick habitat
Questions?? hshapir@toronto.ca