Tick-borne illnesses in Canada - Part 1

Black-legged tickWhen discussing tick-borne illnesses in Canada, the conversation usually begins and ends with Lyme disease. While there is no question that Lyme is the most common of the tick-borne illnesses, there are several others that it's possible to pick up either separately or in combination with Lyme disease.

We don't have great numbers on the rate of occurrence of these illnesses in Canada yet. It was only fairly recently (2009) that Lyme disease became nationally reportable and it remains the only tick-borne illness that is although anaplasmosis and babesiosis are now reportable in Manitoba.

This is the first of two posts spelling out a few of the tick-borne illnesses that Canadians need to be on the lookout for:

Anaplasmosis - Anaplasma is a type of bacteria that attacks white blood cells and its presence has been documented in several regions including southern Manitoba, New Brunswick, Nova Scotia, eastern, southwestern and northwestern Ontario and southern Quebec. Carried by the same ticks as Lyme disease, it can be contracted at the same time. Symptoms can include fever, headache, fatigue, chills, nausea, coughing, confusion, rashes, muscle spasms, breathing difficulties, joint pain, and neurological problems. Although it can be fatal, more typically it causes mild symptoms and most people make a full recovery.

Babesiosis - Babesia is a parasite that infects and destroys red blood cells. It has been detected in Nova Scotia, New Brunswick, Ontario, and Manitoba (with Manitoba having the highest rates). It’s estimated that up to two-thirds of Lyme disease sufferers in the US are infected with a species of babesia. The rates in Canada are presently unknown. On its own, it can cause balance problems, headaches, fatigue, anorexia, muscle and joint pain, chest compression, breathing problems, high fevers, shaking chills, nausea, malaise, drenching night sweats, persistent coughs, and/or vomiting. When combined with Lyme disease, it can create an amped up illness that’s more severe, longer in duration, and has a greater number of symptoms than when either illness arrives alone. Those symptoms can include air hunger, severe headaches, anemia, CNS disturbances, and inflammation of the spinal cord in addition to the symptoms listed above. Many instances of babesiosis produce few or mild symptoms that are often mistakenly attributed to Lyme disease.

Ehrlichia muris-like pathogen (EML) - A new kid on the block that will one day get a formal name, but for now it is simply known as EML. It was first identified seven years ago in the American Midwest and has since migrated into Manitoba. To date there have been less than 100 identified cases including at least one in Canada. Symptoms can include fever, chills, fatigue, nausea, headache, vomiting, diarrhea, coughing, confusion, rashes, arthralgia and neurological disorders. Death appears to be rare but it does occur. This illness is so new that there remain some notable unknowns, but its range is expanding so there will doubtlessly be more cases in this country in the coming years and now that researchers know to look out for it, we will likely be hearing more about this organism in the future.

Powassan Virus (POW) - Named for the community of Powassan, Ontario (southeast of Sudbury) where the deadly virus was first identified, POW has been identified in New Brunswick, Nova Scotia, Prince Edward Island, Quebec, Ontario, Alberta and British Columbia and its territory is expanding. Thankfully this brain scorcher of a disease is quite rare in humans. It tends to make the news every now and again because there is no treatment for it and it is fatal about 10% of the time. It's symptoms include fever, headache, vomiting, weakness, confusion, seizures, speech problems, and memory loss. Roughly half of those who contract Powassan virus develop permanent neurological issues.

Relapsing Tick Fever - Caused by a species of borrelia (Borrelia hermsii) that's closely related to the one that causes Lyme disease, relapsing tick fever is restricted to the Rocky Mountain region of British Columbia where it has traditionally been more common than Lyme disease. The illness is named for its dominant symptom: a dramatic recurring fever that arrives without warning and can last anywhere from one to three days, during which time it easily blasts past 40C then spikes and recedes multiple times. These fevers always end in a crisis that typically involves the abrupt arrival of shaking chills, extreme high fevers, a rapid pulse, high blood pressure and excessive sweating followed by plummeting body temperatures and blood pressure. Symptoms can include total paralysis of an arm, a leg or one side of the body, weakness or impairment of the upper or lower extremities, an unsteady gate, absent reflexes, headaches, backaches, a stiff neck, vertigo, tinnitus, hearing loss or deafness, wide-ranging vision problems, facial palsy, tremors, muscle and joint pain, abdominal pain, language impairment, persistent and/or extreme fatigue, anorexia, nausea, enlarged spleen, vomiting, coughing, delirium, hallucinations, mania, seizures, jaundice, respiratory problems, sensitivity to light, confusion, jaundice, and non-specific rashes. Relapsing tick fever is one nasty customer. The tests for it notoriously cross-react with the tests for Lyme disease, but that's really only an issue if you live in or travel through south central or southeastern British Columbia.

I could go on. In fact, I will go on in my next post when I'll tackle several more of the tick-borne illnesses it's possible to contract in Canada. By the time I'm done, you'll wonder why the conversation rarely moves past Lyme disease when there are so many other pathogens you can pick up from the ticks that continue to expand their territories across our vast and increasingly tick friendly country.

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