Montreal Gazette

Bull’s-eye rash, swollen knee joints among com­mon symp­toms

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“We are not at all in the con­text of a cri­sis,” added Ha­bel, a med­i­cal res­i­dent fo­cus­ing on the pre­ven­tion and con­trol of infectious dis­eases. “We en­cour­age peo­ple to take ad­van­tage of the weather to go out­side.”

Lyme dis­ease, which got its name after it was first di­ag­nosed in Old Lyme, Conn., in the mid-1970s, is caused by the bac­terium Bor­re­lia burgdor­feri when trans­mit­ted by the bite of a tick. Only the deer tick, or black-legged tick, trans­mits the dis­ease in Que­bec, and most cases have been con­cen­trated in the East­ern Town­ships and Mon­térégie.

The most com­mon symp­toms are swollen knee joints and a tell­tale bull’s-eye rash, al­though some in­fected peo­ple do not have the rash. Other symp­toms can in­clude fever, chills, headache, fa­tigue, muscle and joint aches as well as swollen lymph nodes — symp­toms that are so non­spe­cific that it can some­times be dif­fi­cult to di­ag­nose Lyme dis­ease ini­tially.

The dis­ease can be treated with a course of an­tibi­otics over two to three weeks to clear the in­fec­tion. In 10 to 20 per cent of cases, how­ever, treated pa­tients may suf­fer from lin­ger­ing symp­toms of fa­tigue, mus­cu­loskele­tal pains, dis­rupted sleep, and lack of cus­tom­ary men­tal func­tions, ob­serves the New Eng­land Jour­nal of Medicine.

The num­ber of con­firmed cases of Lyme dis­ease in Canada has climbed from 144 in 2009 to 992 in 2016, the fed­eral govern­ment re­ports. Al­though the to­tal in 2016 was high, it’s far be­low the es­ti­mates of 10,000 to 15,000 cases a year that have been pre­dicted by some ex­perts.

Nova Sco­tia re­ports the high­est in­ci­dence of cases of any province, fol­lowed by On­tario and Que­bec. The three prov­inces are re­spon­si­ble for 88 per cent of all cases in the coun­try. “Sur­veil­lance in th­ese three prov­inces in­di­cates that pop­u­la­tions of black-legged ticks have been es­tab­lished for years,” a govern­ment state­ment says.

On the is­land of Montreal, the num­ber of cases in­creased to 46 last year from 25 in 2016. Prior to 2016, the an­nual num­ber of cases was stuck at around 25 since 2013.

“In our in­ter­views, when we speak with peo­ple, we’ve ob­served that they trav­elled to re­gions like the East­ern Town­ships and the Mon­térégie, On­tario and the United States,” Ha­bel said. “Th­ese are res­i­dents of Montreal who go on va­ca­tion and who were bit­ten by a tick out­side Montreal.”

Dr. Christophe­r La­bos, a con­trib­u­tor to the Of­fice for Sci­ence and So­ci­ety at McGill Uni­ver­sity, said Lyme dis­ease is on the in­crease for two rea­sons: much greater aware­ness of the in­fec­tion as well as cli­mate change.

“I think it’s a com­bi­na­tion of the two,” La­bos ex­plained. “I think peo­ple are more vigilant about it now, but part of it is that be­cause of global warm­ing and milder win­ters, you’re get­ting more ticks. The ticks are able to sur­vive through the win­ter.”

Cli­mate change is also re­spon­si­ble for other tick-borne ill­nesses like West Nile virus spread­ing to Canada.

How­ever, the num­ber of cases of peo­ple in­fected with the virus has de­clined from a peak of 428 cases in 2012.

Given the num­bers of cases of Lyme dis­ease, La­bos of­fers a nu­anced mes­sage:

“For the per­son who gets sick, it’s very sig­nif­i­cant be­cause they feel ter­ri­ble and they feel de­bil­i­tated. But it you look at the to­tal num­ber of pa­tients, it’s a very small num­ber com­pared to the whole pop­u­la­tion. So the risk of get­ting Lyme dis­ease is still pretty low.”

 ?? CEN­TERS FOR DIS­EASE CON­TROL/THE AS­SO­CI­ATED PRESS FILES ?? A black-legged (deer) tick, is the only tick to trans­mit Lyme dis­ease in Que­bec. Most cases have been con­cen­trated in the East­ern Town­ships and Mon­térégie.
CEN­TERS FOR DIS­EASE CON­TROL/THE AS­SO­CI­ATED PRESS FILES A black-legged (deer) tick, is the only tick to trans­mit Lyme dis­ease in Que­bec. Most cases have been con­cen­trated in the East­ern Town­ships and Mon­térégie.
 ?? JAMES GATHANY/ THE CANA­DIAN PRESS/AP/CEN­TERS FOR DIS­EASE CON­TROL ?? A “bulls-eye rash” some­times forms after a tick bite.
JAMES GATHANY/ THE CANA­DIAN PRESS/AP/CEN­TERS FOR DIS­EASE CON­TROL A “bulls-eye rash” some­times forms after a tick bite.

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