Nova Sco­tia’s top doc­tor sees no end to spread of Lyme dis­ease


The prov­ince’s chief med­i­cal of­fi­cer says he’s not sur­prised by new statis­tics show­ing a sharp in­crease in re­ported Lyme dis­ease cases in the prov­ince, nor does he an­tic­i­pate a de­cline in in­fec­tions.

“Some of us know that with a change in our cli­mate, and this has been dis­cussed na­tion­ally and in­ter­na­tion­ally, there will be in­creased num­bers of ticks, and we know there will be more hu­man ex­po­sure and more cases of Lyme dis­ease,” Dr. Robert Strang said in a re­cent in­ter­view.

Re­ported cases of Lyme dis­ease in the prov­ince nearly dou­bled in 2017, jump­ing to 586 from 325 in 2016. The statis­tics come from the provin­cial Health Depart­ment’s 2017 re­port on no­ti­fi­able dis­eases.

Strang said he doesn’t ex­pect those num­bers to drop. Strang would not of­fer an es­ti­mate on how many cases could be present in the prov­ince, and which have not been re­ported.

“We’re not go­ing to have the cases come down and we have to ac­cept that Lyme dis­ease is here to stay,” said Strang. “Ticks have been here for­ever and we have to make sure that peo­ple fol­low the proper pre­ven­tion steps.

“I couldn’t say how many cases there are in the prov­ince. We don’t need to know ev­ery sin­gle case to have a ro­bust Lyme dis­ease re­sponse plan. I would not want to ven­ture a guess. We go on our lab­con­firmed cases. That’s more than ad­e­quate for sur­veil­lance pur­poses.”

The Chron­i­cle Her­ald re­cently spoke to a Maine-based doc­tor, Richard Dubocq, who said he’s cur­rently treat­ing 50 Nova Sco­tians for Lyme dis­ease. He said there’s cur­rently no test that can con­clu­sively di­ag­nose the dis­ease. He said it comes down to clin­i­cal di­ag­noses mea­sur­ing trade­mark symp­toms, such as headache, fever and swollen joints. Dubocq of­fers long-term an­tibi­otic ther­apy that can last any­where from six weeks to four years. The treat­ment is not widely ac­cepted in the North Amer­ica com­mu­nity, though it’s rec­og­nized in The In­ter­na­tional Lyme and As­so­ci­ated Dis­eases So­ci­ety’s guide­lines for treat­ment.

Strang says the science does not show long-term an­tibi­otic treat­ment to be ef­fec­tive and does not re­flect cour­ses rec­om­mended by the In­fec­tious Dis­ease So­ci­ety of Amer­ica’s (IDSA) treat­ment guide­lines. But he stopped short of guar­an­tee­ing cur­rent di­ag­noses and treat­ment prac­tices are 100 per cent ef­fec­tive.

“In the early stages, di­ag­noses are based on clin­i­cal symp­toms. When peo­ple have longer-term symp­toms, the test­ing method­ol­ogy that we use is highly ac­cu­rate. The early stages aren’t en­tirely ac­cu­rate to make a clin­i­cal di­agno- sis and treat. No lab test is 100 per cent ac­cu­rate.

“But short cour­ses of an­tibi­otics will ef­fec­tively deal with Lyme dis­ease. There are some peo­ple who have resid­ual symp­toms postLyme dis­ease, but that does not mean they have on­go­ing in­fec­tion.”

Strang said the depart­ment has worked closely with pri­mary-care providers to en­sure they’re able to di­ag­nose and treat.

“We con­tinue to do a lot of work with the pub­lic. If they have symp­toms they’re more likely to seek care. Early Lyme dis­ease is very treat­able with an­tibi­otics. We’ve done a lot of work with pri­mary care providers to rec­og­nize Lyme dis­ease. I dis­agree that we don’t have the abil­ity to di­ag­nose and treat.”

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