Lyme Disease - The Manitoba Story

Lyme Disease in Manitoba

In late 1998 a law was passed and Lyme Disease is now reportable as of January 1999.

In the 1991 Consensus Conference on Lyme disease, Manitoba recorded 17 cases of LD. Of those, 12 contracted the disease in Manitoba⁽³⁾. All theses cases have been taken off Manitoba books. Why? ⁽⁷⁾

Lyme disease (LD) is a tick-bome infection, which begins with a bite from a tick. The initial symptoms are a bulls-eye rash in 40-60 % of cases, followed by flu-like illness with low grade fever, headaches, aches and pains that come and go. These are symptoms that should be checked by your physician. Prompt treatment is essential to prevent Late Stage Lyme which can be very debilitating. Some symptoms are arthritic, neurologic, and cardiac difficulties. It is known as the Great Imitator and imitates a wide range of diseases. A serological study done in 1988 on 320 frozen blood samples, 72 (22%) tested positive and of 110 samples, 21 (19%) tested positive for antibodies to Borrelia burgdorferi (BB). Antibodies were detected in samples from all health regions but mainly from those in the southern parts of the province. The breakdown was as follows:

Thompson 10%,
Northern Manitoba 30%,
Parkland 30%,
Western Manitoba 27.5%,
Interlake 27%,
Central 20%,
Winnipeg l0%.

In 1989 a total of 93 persons reported a EM-like rash, 51 of these were seen by a physicians, of those 28 received antibiotics. Forty-two people with the rash reported exposure to ticks in Manitoba, 6 in Northwestern Ontario, and 13 in other geographic areas.⁽¹⁾ Data from research project done at Cadham Lab, tested 633 blood samples from randomly picked patients of those, 83 were highly positive.⁽²⁾ Further research needs to be done in order to understand why such large numbers tested positive for Lyme disease. This research has been ignored for more than ten years.

Ixodes scapularis (Is) ticks sometimes known as Blacklegged ticks which are known to carry Lyme disease were collected from the following areas in Manitoba: ⁽⁴⁾

1988-1994: Gunton, Balmoral, Flin Flon, Stonewall, Mordon, Selkirk, Matlock, Oakbank, Delta Marsh ⁽⁴⁾
1995-1996: Killarney, Birdshill Park, Madock (San Souci) Beaudry Park or Labarriere Park)⁽⁴⁾
1995-1996 WINNIPEG - Tuxedo **Garden City, Fort, Richmond, Charleswood, & 3 unrecorded areas. ⁽⁴⁾ In 1996 Passive surveillance done by Dr. Terry Galloway and Manitoba Health, netted a total of 15 I. scapularis ticks. Only 5 of the 15 were sent for testing. In late fall Dr. Galloway received a tick** off a dog from Garden City area with no travel outside of the city. The tick was sent to LCDC Ottawa where it tested negative by darkfield microscopy and IFA for Lyme disease, but the bacteria that causes Lyme D. was cultured from the tick.⁽⁴⁾ This is an indication of how limited our tests are for Lyme disease, It was determined in the B.C. Provincial. Lab using PCR testing that it was Borrelia burgdorferi, by Dr. Banerjee.
1997 a total of 10 deer ticks from these areas: 3 Winnipeg, 2 Birds Hill Park, 1 Winnipeg or Birds Hill, 2 East Selkirk, Warren, Oakbank or Dugald. These ticks sent for testing to LCDC in Ottawa by Dr. Terry Galloway U.of M. ⁽⁶⁾
1998 a total of 23 deer ticks were found in the following areas: Winnipeg 10; 2 from St. Vital, St. James, Wolseley, Inkster, 2 from Charieswood, River Heights, possibly St. Vital or Bossevain. Rural 13; Cartier, Birds Hill, Souris, 2 from Selkirk, Argyle, Oak Bluff, Lundar, East St. Paul, Selkirk or Whiteshell, Beausejour, Libau.
1996-1997 DEER TICKS ON BIRDS First report of Blacklegged ticks on birds in Manitoba.⁽⁵⁾ From spring of 1996 to fall of 1997 3 different types of ticks were found on songbirds during bird banding at Delta Marsh: 10 I.s. (deer ticks) and 2 I. muris (mouse ticks) and 4 rabbit ticks. One larval and 9 nymphal ticks. Most were collected during spring migration however one blacklegged nymph was collected on August 3 1996 which indicated that it was picked up locally.
2001 Tick collection Study A passive surveillance Program ⁽⁹⁾ collected 272 ticks from Manitoba, including 177 dog ticks (Dermacentor variablis) and 68 blacklegged ticks (Ixodes Scapularis) and small numbers of other species of ticks. Of the 68 blacklegged ticks, five were found to be infected with Borrelia burgdorferi, the spirochete causing Lyme disease!
Locations of Infected Ticks

REMOVAL OF TICKS
If the tick is still on the skin remove it with fine-tipped tweezers. Grasp tick as close to the head pull straight out with steady pressure.

Save the tick (preferably alive) in a medicine vial or screw top jar with moist paper towel, if that is not available a blade of grass will keep the tick from drying out. (Keep in ziplock bag)
Wash hands and disinfect the tweezers and the bite site. Do not handle tick with bare hands.
Mark the date and location of the bite on a calendar.
If you develop a rash or symptoms, see your doctor and take the tick with you.

Never squeeze or prick the tick's body as this may cause fluids to be injected into your body.
Never try to remove or kill the tick by suffocating it with Vaseline, nail polish, or burning it with a match or cigarette. Such irritants may cause the tick to spew bacteria into you.
Never allow children to attempt the removal of a tick by themselves, They should be warned not to touch the tick and seek help of an adult.

The Aims and Objectives of the Lyme
Disease Support Group of
Manitoba.

Develop dialogue between Lyme disease sufferers and Health care givers for a better understanding of Lyme disease.
Development of educational programs on Lyme disease prevention for schools.
Work towards developing a positive alliance with health care workers.
Place information brochures and video tapes on Lyme disease into the libraries in Manitoba.
Work towards recognition by setting up the proclamation of a Lyme Awareness week in Manitoba.
Establish funding and co-ordinate volunteers to collect rodents and ticks for research to establish that the disease is circulating in our Manitoba rodents and ticks.
Set up communications for out of province research on the collected rodents and ticks.
Set up an awareness cmnpaign for campers, hikers and hunters exposed to the possibility of tick-borne diseases.
Work with other Support groups with similar goals across Canada, US and abroad.

The Lyme Disease Support Group of Manitoba has heard from numerous people who have had difficulty getting prompt treatment. Patients who are not given appropriate treatment early, can develop late-stage symptoms that are more and more debilitating. Patients and their families suffer physically, emotionally and mentally due to improper diagnosis or treatment.
(1) Sekla L., MB Bach. Stackiw, W. B.SC., Poffenroth, I MD. Field Entomologist, Lyme Disease in Mb. CDWR 1990 16: 147-152, 149.
(2) Freedom Of Information Package.
(3) Consensus Statement on Lyme Disease CDRW 1991 17:66.
(4) Personal Communication, Dr. T. Galloway, Ph.D. Professor University Of MB.
(5) John Scott, Ms Heidi den Haan, Lyme Alert, Volume 8, No. 1, Jan-Mar 1998.
(6) Personal communication, Dr. Terry T. Galloway,
(7) What You Should Know About Lyme Disease, Manitoba Health Publication.
(8) Personal communication, Dr. Robbin Lindsay,
(9) Lindsay LR, Dibernardo, A., Galloway, TD. Ticks Submitted During the Manitoba Health Passive Surveillance Program, 2001.

OUR MISSION ...
To increase the awareness and understanding of Lyme and other tick-bome diseases among the public and health care professional, thus to reduce the number of cases in Manitoba. When hiking, camping or enjoying the great outdoors, just take time to prevent disease by checking and thus protecting yourself.
If you live in Manitoba, have been bitten by a tick, have symptoms resembling Lyme Disease, and have not been treated, please contact the Manitoba Minister of Health (Dave Chomniac) at minhlt@leg.gov.mb.ca.

Lyme Disease Support
Group of Manitoba
for more information call (204-373-2495)
Or write to: Box 598
30 Seventh Street
Emerson, MB
R0A 0L0