{"id":2593,"date":"2024-05-24T00:00:00","date_gmt":"2024-05-24T05:00:00","guid":{"rendered":"https:\/\/mdbc2.wpenginepowered.com\/blog\/navigating-tick-season-in-canada-essential-guidance-for-physicians\/"},"modified":"2024-05-24T00:00:00","modified_gmt":"2024-05-24T05:00:00","slug":"navigating-tick-season-in-canada-essential-guidance-for-physicians","status":"publish","type":"blog","link":"https:\/\/www.mdbriefcase.com\/fr\/blog\/navigating-tick-season-in-canada-essential-guidance-for-physicians\/","title":{"rendered":"Navigating Tick Season in Canada: Essential Guidance for Physicians"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">Lyme disease is on the rise in Canada. In 2009, Canada saw only 144 reported cases, which surged to\u00a0<\/span><a href=\"https:\/\/www.canada.ca\/en\/public-health\/services\/diseases\/lyme-disease\/surveillance-lyme-disease.html#a1h\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">3,147 by 2021<\/span><\/a><span style=\"font-weight: 400;\">, and analysis suggests the trend will continue with\u00a0<\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC10863724\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">climate change<\/span><\/a><span style=\"font-weight: 400;\">. Here&#8217;s what to know as the tick season approaches.\u00a0<\/span><\/p>\n<h2><b>Understanding Tick-Borne Diseases in Canada<\/b><\/h2>\n<p><a href=\"https:\/\/www.canada.ca\/en\/public-health\/services\/diseases\/lyme-disease\/health-professionals-lyme-disease.html\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Tick-borne diseases<\/span><\/a><span style=\"font-weight: 400;\"> develop after a patient contracts a viral, bacterial, or parasitic infection from an infected tick. There are a few diseases that affect humans, each caused by a different organism, including:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Anaplasmosis<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Babesiosis<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Tick-borne relapsing fever<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Lyme-like disease<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Lyme disease<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Lyme disease is the\u00a0<\/span><a href=\"https:\/\/ncceh.ca\/resources\/evidence-reviews\/review-ticks-canada-and-health-risks-exposure#:~:text=Lyme%20disease%2C%20caused%20by%20the,borne%20infection%20in%20North%20America.&amp;text=Symptoms%20for%20Lyme%20disease%20vary,to%2030%20days%20after%20exposure.\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">most reported tick-borne disease<\/span><\/a><span style=\"font-weight: 400;\"> in North America and affects\u00a0<\/span><a href=\"https:\/\/www.publichealthontario.ca\/data-and-analysis\/commonly-used-products\/reportable-disease-trends-annually#\/34\"><span style=\"font-weight: 400;\">7.7 people for every 100,000<\/span><\/a><span style=\"font-weight: 400;\"> in Canada alone.\u00a0<\/span><\/p>\n<h2><b>Educating Patients on Prevention<\/b><\/h2>\n<p><span style=\"font-weight: 400;\">Any tick can carry infections that cause disease, and patients may not know they\u2019re exposed. The best way to avoid disease is to prevent bites. <\/span><span style=\"font-weight: 400;\">Advise patients<\/span><span style=\"font-weight: 400;\"> to:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Avoid tick-infested areas, especially leafy areas and long grass<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Wear long pants and sleeves in tick areas<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Tuck pants into socks\u00a0\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Wear close-toed shoes<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Use repellent on skin, shoes, and clothes<\/span><\/li>\n<\/ul>\n<h2><b>Recognizing Symptoms and Risk Factors<\/b><\/h2>\n<p><span style=\"font-weight: 400;\">Patients may experience Lyme disease symptoms early on, within three to 30 days of a tick bite, known as\u00a0<\/span><a href=\"https:\/\/www.canada.ca\/en\/public-health\/services\/diseases\/lyme-disease\/health-professionals-lyme-disease.html\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">early localized disease<\/span><\/a><span style=\"font-weight: 400;\">. It usually presents as an acute illness with symptoms such as:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Fever<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Muscle pain<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Headache<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Fatigue<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Migratory joint pain<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Swollen lymph nodes<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Red rash called erythema migrans or bull\u2019s eye rash<\/span><\/li>\n<\/ul>\n<h3><b>Disease Stages and Symptoms<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">The remaining stages are known as early disseminated disease and late disease.\u00a0<\/span><a href=\"https:\/\/www.canada.ca\/en\/public-health\/services\/diseases\/lyme-disease\/health-professionals-lyme-disease.html\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Early disseminated disease<\/span><\/a><span style=\"font-weight: 400;\"> develops within less than three months of a bite as bacteria spread to other organs and tissues.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Early disseminated disease causes:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Erythema migrans rash: An erythema migrans rash expands to greater than 5 cm in diameter at the site of the tick bite.\u00a0\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Fatigue\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Weakness<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Joint and muscle pain<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Aseptic meningitis<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Encephalitis<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Cranial neuropathy<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Radiculitis<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Conjunctivitis<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Carditis heart block<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Late disease<\/span><span style=\"font-weight: 400;\"> occurs three months or more after a bite and can last for months or years. It usually advances when patients don\u2019t know they\u2019ve been bitten and infected or haven\u2019t received suitable treatment. Symptoms are similar to early disseminated disease but may be more pronounced and widespread.\u00a0Possible manifestations can include:<\/span><\/p>\n<p><b>Musculoskeletal:<\/b><\/p>\n<ul>\n<li>Baker&#8217;s cyst<\/li>\n<li>intermittent episodes of pain and\/or swelling in one or multiple joints, particularly the knees and other large joints leading to chronic arthritis<\/li>\n<li>if untreated, arthritis may recur in the same or different joints<\/li>\n<\/ul>\n<p><b>Neurological and cognitive:\u00a0<\/b><\/p>\n<ul>\n<li>meningitis<\/li>\n<li>meningoencephalitis<\/li>\n<li>subacute mild encephalopathy, affecting:\n<ul>\n<li>memory<\/li>\n<li>concentration<\/li>\n<\/ul>\n<\/li>\n<li>myelitis<\/li>\n<li>cranial neuropathy<\/li>\n<li>radiculopathy<\/li>\n<li>chronic mild axonal polyneuropathy, manifested as:\n<ul>\n<li>distal paresthesia<\/li>\n<li>radicular pain (less common)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><b>Rare forms of presentation include:<\/b><\/p>\n<ul>\n<li>encephalomyelitis<\/li>\n<li>leukoencephalopathy<\/li>\n<li>diaphragmatic paralysis caused by phrenic nerve palsy leading to tick-induced respiratory paralysis or respiratory distress<\/li>\n<\/ul>\n<h2><b>Diagnostic Approaches<\/b><\/h2>\n<p><span style=\"font-weight: 400;\">Lyme disease diagnosis occurs through clinical presentation and examination of a history of exposure to ticks and clinical signs and symptoms. However, patients may present with generalized symptoms without noticing the hallmark bull\u2019s eye rash. In these cases, order additional testing to confirm.<\/span><\/p>\n<h2><b>Laboratory Confirmation<\/b><\/h2>\n<p><span style=\"font-weight: 400;\">Lyme disease testing in Canada follows a\u00a0<\/span><a href=\"https:\/\/www.canada.ca\/en\/public-health\/services\/diseases\/lyme-disease\/health-professionals-lyme-disease.html#two_tiered\"><span style=\"font-weight: 400;\">two-tiered approach<\/span><\/a><span style=\"font-weight: 400;\">. Start with an enzyme immunoassay (EIA) to identify antibodies to\u00a0Borrelia burgdorferi. If the result is positive or equivocal, follow up with confirmatory immunoblots, such as the western blot, IgG, or IgM immunoblots.\u00a0<\/span><\/p>\n<h2><b>Treatment Strategies<\/b><\/h2>\n<p><span style=\"font-weight: 400;\">Antibiotics, specifically doxycycline, cefuroxime axetil and amoxicillin are the most commonly recommended \u00a0first-line treatment for Lyme disease, however doxycycline is not recommended for pregnant people. Oral antibiotics are most effective in the early stages. Late disease may require\u00a0<\/span><a href=\"https:\/\/canlyme.com\/treatment\/\"><span style=\"font-weight: 400;\">intravenous antibiotics<\/span><\/a><span style=\"font-weight: 400;\"> for several months. Patients who can\u2019t tolerate antibiotics may benefit from intramuscular versions, which release slowly.<\/span><\/p>\n<h2><b>Post-Exposure Prophylaxis (PEP) and Referrals<\/b><\/h2>\n<p><span style=\"font-weight: 400;\">Patients who can confirm specific criteria following a tick may qualify for\u00a0<\/span><a href=\"https:\/\/cep.health\/media\/uploaded\/CEP_EarlyLymeDisease_Provider_2020.pdf\"><span style=\"font-weight: 400;\">preventive treatment<\/span><\/a><span style=\"font-weight: 400;\"> with a single dose of doxycycline. The criteria include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Verified black-legged tick<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Attached for 24 hours or more and engorged<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Tick was from a known infested area<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Treatment can start with 72 hours of a bite<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">It is not 100 percent effective, so patients should watch for symptoms for 30 days. Refer back to their primary physician for follow-up.<\/span><\/p>\n<p align=\"center\">+ + +<\/p>\n<p><span style=\"font-weight: 400;\">Stay at the forefront of patient care &#8211; <\/span><a href=\"https:\/\/www.mdbriefcase.com\/fr\/user-account\/?action=eb_register\"><span style=\"font-weight: 400;\">join MDBriefCase<\/span><\/a><span style=\"font-weight: 400;\"> for free today to access hundreds of interactive CME courses on a variety of health topics.\u00a0<\/span><\/p>","protected":false},"excerpt":{"rendered":"<p>Lyme disease is on the rise in Canada. In 2009, Canada saw only 144 reported cases, which surged to\u00a03,147 by 2021, and analysis suggests the trend will continue with\u00a0climate change. Here&#8217;s what to know as the tick season approaches.\u00a0 Understanding Tick-Borne Diseases in Canada Tick-borne diseases develop after a patient contracts a viral, bacterial, or [&hellip;]<\/p>\n","protected":false},"featured_media":2594,"template":"","meta":{"_acf_changed":false,"inline_featured_image":false},"categories":[1],"class_list":["post-2593","blog","type-blog","status-publish","has-post-thumbnail","hentry","category-uncategorized"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Navigating Tick Season in Canada: Essential Guidance for Physicians - MDBriefCase<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.mdbriefcase.com\/fr\/blog\/navigating-tick-season-in-canada-essential-guidance-for-physicians\/\" \/>\n<meta property=\"og:locale\" content=\"fr_CA\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Navigating Tick Season in Canada: Essential Guidance for Physicians - MDBriefCase\" \/>\n<meta property=\"og:description\" content=\"Lyme disease is on the rise in Canada. 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