1. LYME DISEASE Carla Booth

2. Outline  Lyme Disease  Hosts and Parasite  Life cycle of Borrelia burgdorferi  Ticks  Where is this Emerging Disease  Recent studies  Local responses

3. History of Lyme Disease  Early 20 th century European physicians noticed the slowly growing red rash  1940’s linked rash to multi system illness  1969 successful treatment with penicillin  1970 large number of children with advanced symptoms (Arthritis) in Lyme Conneticut  1982 Borrelia bacteria identified in association with the rash  1984 conclusive evidence that Borrelia burgdorferi caused LD  1982 started surveillance for LD in North America

4. Lyme Disease  Infection of human, or animals caused by bacteria Borrelia burgdorferi  Described in Lyme, Conneticut hence it’s name  100, 000 cases since 1982 in North America  Some symptoms include:  EM or erythema migrans (bulls eye rash)  Fever  Fatigue  Enlarged lymph nodes  Headaches  Arthralgia (joint pain)  Arthritis  Radiculitis (inflammation of spinal nerve root)  Cranial nerve palsies

5. Life Cycle Note that it can infect multiple hosts (humans, deer, small rodents, birds, ticks, dogs etc) http://www.textbookofbacteriology.net/Lyme_3.html

6. Ticks  Recall the tick Dermacentor spp. causes Ghost Moose  The tick that serves as a vector for Lyme Disease (LD) is Ixodes spp. (I. scapularis, I. pacificus)  Hard tick, black legged tick Black legged Tick

7. Recent Studies  Plethora of websites claiming emergence of ticks carrying LD, symptoms and preventative measures to be followed  Less scholarly papers/data available... however  Study in United States  Study in Eastern Canada (Ontario and Quebec)  Alberta?

8. Where in North America  Canada: southern and southeastern Quebec, southern and eastern Ontario, southeastern Manitoba, New Brunswick and Nova Scotia as well as much of southern British Columbia.  United states: multiple eastern states, California, Texas, and Florida  The states were ranked in order of highest to lowest number of reported cases http://www.menstuff.org/issues/byissue/lymedisease.html#rising

9. United States  Risk Map of US  Predicted LD risk in States  2002 23,763 cases reported to CDC  95% from Conneticut, Delaware, Rhode Island, Maine, Maryland, Massachusetts, Minnesota, New Jersey, New Hampshire, New York, Pennsylvania, and Wisconsin http://www.menstuff.org/issues/byissue/lymedisease.html#rising

10. Eastern Canada  Study: Vets collected ticks from resident dogs for 1997-1998  Map of Southern Ontario  5.8% infected with B. burgdorferi  Possible spread of infection to places where unifected ticks are established http://0-web.ebscohost.com.darius.uleth.ca/ehost/pdfviewer/pdfviewer?sid=dd48976a-126f-4d39-b259-c738004a6c34%40sessionmgr11&vid=14&hid=8

11. Eastern and Central Canada  The spread of LD also due to the expansion of where the vector species of tick (I. scapularis) found  Up to 1997 only confirmed population in Long Point Ontario  Temperature change with global warming is aiding the spread of the tick  Northward migrating land birds as potential mode of expansion

12. Eastern and Central Canada http://0- web.ebscohost.com.darius.uleth.ca/ehost/detail?sid=934c4b9 9-a958-400a-b3ee- 003d5687cfda%40sessionmgr11&vid=1&hid=7&bdata=Jn NpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#db=a9h&AN= 35703445 Projected spread in the International Journal of Health Geographics  Used temperature predictions from the CGCM2 climate model  Developed an algorithm to predict occurrence in Canada

13. Eastern and Central Canada http://0- web.ebscohost.com.darius.uleth.ca/ehost/detail?sid=934c4 b99-a958-400a-b3ee- 003d5687cfda%40sessionmgr11&vid=1&hid=7&bdata=J nNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#db=a9h&A N=35703445 http://0-web.ebscohost.com.darius.uleth.ca/ehost/pdfviewer/pdfviewer?sid=f37296bd- 1f1f-4654-87ef-416e0841fb73%40sessionmgr11&vid=2&hid=8 No. of ticks/human population >0 and >6.11*10 -4 6.11*10 -4 To 1.761*10 -3 1.762 *10 -3 to 3.300 *10 -3 3.300 *10 -3 to 7.463 *10 -3 7.464 *10 -3 to 2.584 *10 -2 20081990-2003

14. Closer to home...? http://www.srd.alberta.ca/RecreationPublicUse/WildlifeViewing/MedicineHat GrasslandWater/CypressHillsProvincialPark/Default.aspx http://wildobs.com/place/Cypress-Hills-Provincial-Park-SK http://insciences.org/article.php?article_id=4568  Potential of spreading infection if established in the white tailed deer population of Cypress Hills

15. Closer to home  Video clip  http://www.ctv.ca/CTVNews/Health/20100521/ly me-ticks-alberta-100521/ http://www.ctv.ca/CTVNews/Health/20100521/ly me-ticks-alberta-100521/  Suggestions made that the adult ticks may have been carried in by migrating birds coming not from the east but from BC  Need more research in the West!

16. References  Banerjee, S. N., Banerjee, M., Fernando, K., Scott, J. D., Mann, R., & Morshed, M. G. (2000). Presence of spirochete causing Lyme disease, Borrelia burgdorferi, in the blacklegged tick, Ixodes scapularis, in southern Ontario. Canadian Medical Association Journal, 162 (11), 1567-1569.  Bankhead, T., & Chaconas, G. (2007). The role of VlsE antigenic variation in Lyme disease spirochete: persistence through a mechanism that differs from other pathogens. Molecular Microbiology, 65 (6), 1547- 1558.  Beware of deer ticks. (2009). Retrieved 03 28, 2011, from Daily Herald Tribune: http://www.dailyheraldtribune.com/ArticleDisplay.aspx?archive=true&e=1293404  Gilmore Jr., R. D., Mbow, L. M., & Stevenson, B. (2001). Analysis of Borrelia burgdorferi gene expression during life cycle phases of the tick vector Ixodes scapularis. Microbes and Infection, 3 (10), 799-808.  Isolation of Borrelia burgdorferi, The Lyme disease spirochete, from rabbit ticks, Haemaphysalis leporispalustris — Alberta. (2011). Retrieved 03 28, 2011, from Canadian Lyme Disease Foundation: http://www.canlyme.com/alberta.html  Lyme Disease. (2011). Retrieved 03 28, 2011, from Government of Alberta:Health and Wellness: http://www.health.alberta.ca/health-info/lyme-disease.html  Lyme's Disease. (1996-2011). Retrieved 03 28, 2011, from Menstuff: http://www.menstuff.org/issues/byissue/lymedisease.html#rising  Odgen, N. H., Lindsay, L. R., Morshed, M., Sockett, P. N., & Artsob, H. (2009). The emergence of Lyme disease in Canada. Canadian Medical Association Journal, 180 (12), 1221-1224.  Odgen, N. H., St. Onge, L., Barker, I. K., Brazeau, S., Bigras-Poulin, M., Charron, D., et al. (2008). Risk maps for range expansion of the Lyme disease vector, Ixodes scapularis, in Canada now and with climate change. International Journal of Health Geographics, 7, 1-15.

17. Questions