Climate change brings Lyme disease to Canada

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      Jim Wilson, founder of the Canadian Lyme Disease Foundation (CanLyme) was in an Ottawa hotel room, in lockdown, with his curtains drawn when the Georgia Straight caught up with him. It was October 22, that terrible day of the shootings at Parliament; Wilson had flown from B.C. to the nation’s capital to testify in front of a parliamentary committee regarding Bill C-442, an Act Respecting a Federal Framework on Lyme Disease.

      Parliament resumed the day after the tragedy, but Wilson doesn’t know when discussion of the bill will be rescheduled. Until then, he’ll continue his fight to improve the detection, diagnosis, prevention, and treatment of Lyme disease, which he has and which is the most common tick-borne illness in North America.

      “It is so important that the patients—and they’re experts—be brought into the policymaking process,” Wilson said. “We’ve been dictated to by a really small group of Canadian specialists on Lyme disease who are part of the Association of Medical Microbiology and Infectious Disease Canada. They just put out a position statement on Lyme disease and it’s archaic.

      “They don’t acknowledge the prevalence of Lyme disease,” he said. “It’s much more prevalent than what they’re reporting. They’re relying on the same old two-tiered testing process that is limited to looking for only one strain [of bacteria] of one species. What they’re doing right now is trying to calm the public into this state of complacency.”

      Some experts say that Lyme disease could become even more commonplace with global warming.

      The number of reported cases across the country increased from 128 in 2009 to an estimate of more than 500 in 2013, according to a June 3, 2014, statement before the parliamentary committee by Steven Sternthal, acting director general of the Centre for Food-borne, Environmental and Zoonotic Infectious Diseases, a division of the Public Health Agency of Canada’s Infectious Diseases Prevention and Control Branch.

      Sternthal declined to be interviewed, but in his statement he explained that Lyme disease is one of the most rapidly emerging infectious diseases in North America. Its spread is being driven in part by climate change, he noted, as the ticks move here from endemic areas of the U.S.

      “Moving into Canada, it is impacting our most densely populated regions,” Sternthal told the committee. “We anticipate the disease will affect over 10,000 Canadians per year by the 2020s.”

      The estimated number of cases is at least three times lower than actual cases, Sternthal noted, because people may not seek treatment for milder symptoms or may be misdiagnosed because doctors are not always aware of the range of signs. According to CanLyme, symptoms can include everything from hair loss and headache to blurry vision and confusion.

      The effect of climate change on the prevalence of Lyme disease is something the B.C. Centre for Disease Control (BCCDC) is monitoring.

      “We’ve been involved in some modelling to determine if the range of the black-legged tick could change with climate change, and the answer is yes: the black-legged tick could move further north and have new habitat,” said Dr. David Patrick, medical epidemiology lead for the BCCDC’s antimicrobial resistance and director of UBC’s school of population and public health. “Certainly, if we experience real warming, we’ll see a change in the distribution of mosquitoes and we’ll see a change in the distribution of ticks.”

      He also said, however, that the impact of global warming on tick distribution could be more pronounced in other parts of the country than in B.C., which has a unique climate and ecology.

      “There’s no doubt it’s increasing around Lunenburg and southern Nova Scotia and the Niagara region,” he said. “In B.C., we’ve been looking actively to see if it’s increasing and the answer is no. We see Lyme bacterium in about one in 200 black-legged ticks in B.C., and that has not changed in a long time. It’s the same with Washington and Oregon.”

      CanLyme board member and entomologist Janet Sperling, who is a PhD student in Alberta studying the microbiome of the black-legged tick, said global warming is having more of an effect on the spread of Lyme disease in eastern parts of Canada than in B.C.

      She also maintained that people here need to be vigilant about protecting themselves from ticks not just in the summer months—when awareness campaigns typically take place—but in the wetter, colder months.

      “You want to cover up and always be mindful that you could run into ticks,” she said by phone, noting that bugs may also carry a genus of bacteria called Rickettsia. “In the summer months, you’re more likely to be wearing shorts and T-shirts, whereas in November you’re more likely to be wearing long pants.

      “Based on submissions by people who have been affected by Lyme disease, the summer months are the least likely time to find Lyme ticks in B.C. and yet at the same time [they are] the most likely months for the BCCDC to go looking for ticks,” she added.

      Wilson said he contracted the illness in 1991 while living in Dartmouth, Nova Scotia, but only got diagnosed years later after relocating to Squamish. He said he was extremely ill until he began taking several rounds of antibiotics.

      “I went from being so sick to getting my life back,” Wilson says. “It was a long process, not just a short round of antibiotics. Every time I quit taking antibiotics, I would relapse. I lost my brain function. I had neurological issues. I had muscle spasms and tics, and my legs were like rubber. I choked on my food and drooled when I talked….It was horrible.”

      Wilson said his two kids also contracted Lyme within one year of each other in B.C., but doctors here told them they were disease-free. After sending their blood for testing in the U.S., they got the diagnosis. His family’s experience with the illness is what prompted him to start CanLyme.

      The BCCDC’s Patrick cautioned that there is much misinformation on the Internet and claimed that testing done in Canada is backed by rigorous research.

      “It is true in some places that doctors have missed a diagnosis early, and that has led to problems,” he said. “But a problem that is larger, in my view, is that people are being persuaded by the Internet to send their blood away for tests in alternative U.S. labs claiming to be Lyme specialty labs, and these labs are observably giving a whole bunch of false-positive results. I’m hearing stories like this every week: a lady diagnosed with Lyme who’s treated with copious amounts of antibiotics then proceeds to lose her vision…and the problem is this diagnosis of Lyme has delayed the diagnosis of MS. So when I say I’m worried about this test, it’s not because I’m trying to dump on the labs but because I’m concerned about patient safety in B.C.” 

      If you get bitten by a tick, you want to remove it quickly and put it in a jar with a lid, Patrick said; this necessitates a quick body inspection after outdoor activities in areas that host black-legged ticks, especially for children. The arachnid can be submitted to a lab and tested for Lyme. Sperling said ticks like to hide in places like your hair, groin, or belly button. She said people who are concerned about having contracted a tick-borne illness should seek medical attention.

      “If you think there’s something wrong, go and get a second opinion,” she said. “Ticks are a problem, [but] don’t let them prevent you from getting out and doing exercise.”

      Follow Gail Johnson on Twitter at @gailjohnsonwork.




      Oct 29, 2014 at 10:46pm

      Dr. Patrick alleges one patient lost their eyesight due to a misdiagnosis. Lyme disease can cause a loss of eyesight. The US labs he refers to are run by PhD microbiologists and immunologists who simply refuse to test for only one strain of one species like the BC CDC. Scientists can't even decide what is a strain and what is a species of the Lyme bacteria but they know it has a wide diversity. Those US labs he says are "claiming" to be specialty labs are not just claiming, they are specializing. This is unlike the BC CDC who has simply ceded their responsibility to the US government labs whose criteria was shown to be terrible by tons of research in the 1990's. Even Health Canada reported in 2012 that Canadian tests were not capable of detecting the genetic diversity of the Lyme bacteria... so just how did Dr. Patrick, et al, determine that lady did not have Lyme disease? They are misinforming the public about the ability of their diagnostic process.


      Oct 30, 2014 at 2:08pm

      "The BCCDC’s Patrick cautioned that there is much misinformation on the Internet and claimed that testing done in Canada is backed by rigorous research." - Patrick is the one spreading misinformation. Canada's 2-tiered Elisa Lyme test that doctors are forced to use has a high false neg rate. This is even posted on Health Canada's Adverse Reaction Newsletter, Volume 22, Issue 4. It only tests for 2 strains of the bacteria whereas the U.S has a more sensitive and selective testing system. Patrick needs to educate himself on Lyme disease and get his head out of the sand with his archaic beliefs!

      Penny Trask

      Oct 30, 2014 at 2:43pm

      Thank you so much Jim Wilson, for your perseverance and dedication to this awful disease. Without your support, my daughter Taylor may have once again been misled by our medical system here in Canada. Her MD urged her to leave it alone and could or would not read her positive blood tests from Igenix. Thank you for directing her to someone who could help her. My daughter contracted Lyme in Alberta and since she has had a diagnosis, I have heard from at least 5 others who have contracted lyme here in Alberta.

      David Patrick

      Oct 30, 2014 at 6:31pm

      Actually, to Jim's comment, we hear unfortunate stories of patient misadventure very regularly. These have included life-threatening line sepsis and yes, death from complications of treatment of allergic reaction from unnecessary antibiotics. The problem with using flawed tests to draw a conclusion about what is causing a problem for sick people is that they put the blinders on. Health care workers and researchers can stop looking for far more plausible causes. No argument that sick people need good care - but a quick and dirty answer based on a flawed test is a significant threat to patient safety.


      Nov 1, 2014 at 10:17pm

      David Patrick, you refer to death from allergic reaction... you mean anaphylactic shock. Thousands of people suffer anaphylactic shock from many things including bee stings, peanut allergies, antibiotics, etc. and the survival rate is very high. Death is typically from inappropriate response to the shock by either delaying the administration of adrenalin, or the inappropriate administration of adrenalin. You are using flawed tests, flawed mathematical calculations into which you enter your variable about known risk, and you gather your variable data from a very flawed process. You have even told people with positive results that their positive test was magically a false positive. It is amazing David that Health Canada states the current tests are incapable of detecting the genetic diversity within the genus borrelia (because they are strain limited) and yet those are the very tests the BC CDC uses... a flawed test. You have determined other independent labs run by PhD microbiologists and immunologists, of which you are neither, are flawed yet you consistently fail to recognize what the rest of the world knows via published research... it is your test that is terribly flawed and has been for decades. David, why don't you lay out here for the world of scientists and mathematicians to see, the calculations you use to determine validity of a test result. You repeat them regularly but never to other experts.

      Scratching my head

      Nov 2, 2014 at 1:44pm

      I find the vague and patronizing dismal of patients by Dr. Patrick to be concerning. His blanket statement that "people are being persuaded by the Internet to send their blood away for tests in alternative U.S. labs claiming to be Lyme speciality labs," is an odd and inaccurate generalization.

      People in the Lyme Disease community in BC are aware he is referring to a licensed and accredited laboratory based in California. If he thinks the US laboratory is producing inaccurate results he should identify the laboratory and then we can have an open and vigorous discussion on the merits of the lab's actual testing methods (which have been accredited by numerous state health departments) rather than conveniently dismissing all positive US test results.

      Furthermore, Dr. Patrick should openly discuss his views on the pre-test probability model he endorses. The application of this mathematical model to Lyme disease test results in BC (which Dr. Patrick believes to be a low prevalence area) means that the vast majority of blood tests resulting in a "positive" are actually believed to be "false-positive" for people with an established infection. Let's have an open and frank discussion about the use of this model in BC, how that impacts the treatment of Lyme disease patients here and how it factors into the dismissal of positive test results from the United States.

      Scientific knowledge of Lyme disease is growing by the day which is why it is so very disappointing to see weak generalizations and reliance on old science guiding the diagnosis and treatment of Lyme disease in British Columbia today.

      Sheri Mahood

      Nov 2, 2014 at 8:26pm

      Dr. Patrick, I was not persuaded by the Internet to seek testing from Igenex Labs but rather was TOLD BY MY MEDICAL DOCTOR, my GP, to get my blood drawn at a Naturopathic clinic and have my blood sent to IGENEX lab "because our tests are useless" - those were my GP's exact words. Someday the truth will come out and you have to admit just how wrong you have been.

      Melinda Russell

      Nov 2, 2014 at 8:31pm

      The reason we have inadequate testing, while following the same guidelines as the CDC, is very clear. The CDC had a board of 14 men who were to be the decision makers after reading and considering all the scientific reports available, etc. It was admitted by them they did not read the information. Seven of the 14 members of this committee had ties to pharmaceutical companies. Yes, conflict of interest. A few months back there were 30,000 new cases a year. "OOOOOOOPS!!!!! We made a mistake." All of a sudden that figure jumped to 300,000. Can you say vaccine? BTW, those 300,000 were already there, already ill for some time. Just like here in Canada. There are thousands of us going without help. "We don't have lyme here". Interesting how all the ticks and infected animals know how to stop at the border.

      D Hart

      Nov 2, 2014 at 9:03pm

      Wake up medical people ... Lose your egos ... Regain your bought souls from BigPhatPharma & get educated ... What happened to the real doctors? a 10 min. office visit with your face in your computer screens is not an appointment ... shame on all of you & please explain why a veterinarian is heading anything to do with human health care ?? One time respected & nowadays laughed about ... just like your shrink sidekicks ...

      David Lacroix

      Nov 2, 2014 at 9:58pm

      Dr Patrick do you include California igenex lab within the category of "alternative U.S. labs claiming to be Lyme specialty labs" ? Are there any American Lyme disease specialist labs that the Canadian medical recognizes?