My first exposure to ticks was 3 years ago. In the summer of 2015, I returned home from my studies at UBC to work as a tree planter with my local conservation authority. While the job was enjoyable, I will never forget the 3 days of shear torture I spent planting trees at one particular site near Sarnia, Ontario. Why was it torture, you ask? Ticks. Dozens upon dozens of ticks. Now, I’m usually the kind of person to not be bothered by bugs. Bees, spiders, even cockroaches—bring it on. But ticks? No chance in hell. Not only do they quite literally burrow into your skin to fed, they’re tiny, vampiric-looking creatures with the remarkable ability to hide in your clothes, hair, and just about everywhere else. Simply put, if you know anything about The Office (U.S.), ticks are the Toby to my Michael Scott. My absolute fear of these little summer vampires aside, there is something even more terrifying than ticks themselves: Lyme disease.
Among the dozens of diseases around the world that ticks have been shown to carry, Lyme disease is the one that poses a unique and rapidly worsening threat in North America. Lyme disease is an inflammatory infection in humans caused by Borrelia bacteria, which is found in a variety of animals including birds, mice, and deer. Ticks are the main transmission vector of Borrelia, and pick up the bacteria by biting other animals. When humans are bitten by bacteria-ridden ticks, infection occurs.
What makes Lyme disease particularly challenging for physicians is the difficulty of early diagnosis, with Stage 1 infection often presenting with non-specific symptoms such as fever, pain, headaches, and muscle aches. Some cases also present with a “bull’s eye” rash near the site of the tick bite (pictured on right). As Lyme disease progresses, the symptoms worsen dramatically—affecting mental health status, causing chronic fatigue, neurological symptoms like tremors and numbness, as well as even causing chest pain, heart palpitations, and shortness of breath.
The worst part? We had a vaccine for Lyme disease; LYMErix, an effective, albeit relatively expensive vaccine (at $50 USD per dose), was sold from 1998 to 2001. While shown to be over 90% effective at preventing Lyme, LYMErix was withdrawn due to a multitude of factors, most notably due to public pressure on behalf of anti-vaxxers. Their argument? The LYMErix vaccine caused widespread adverse effects, namely musculoskeletal issues like arthritis. This argument, despite little evidence in support of it, still made LYMErix one of the earliest casualties of the still-growing anti-vaccine movement.
Fast forward to today, and I had more or less forgotten about ticks and Lyme disease. That is, until I listened to a particularly interesting episode of Canadaland, a podcast tackling issues in Canadian media and politics (which I highly recommend you listen to, by the way). In this episode, a controversy about a Lyme disease cover-up was mentioned, whereby this originally-removed story in the Halifax Chronicle Herald was replaced in favour of this piece by the province’s chief medical Officer of Health, Dr. Robert Strang. While the first article argued for the existence of significant deficiencies in the Nova Scotia healthcare system in addressing Lyme, Dr. Strang argued the opposite: Lyme disease is under control and not worth worrying about.
Well, Dr. Strang, I respectfully disagree.
While we have come a long way in diagnosing Lyme disease, currently available diagnostic testing is complicated and only available at a handful of centres across the country. And despite my forgetting (or conscious repression) of my nightmare-inducing tick experience, ticks—and Lyme disease—are spreading fast. In Canada, cases of Lyme disease have risen sharply from just 144 reported cases nationwide in 2009 to nearly 1000 cases in Ontario alone in 2017. And just like so many other things, we have climate change to thank for it. Rising temperatures have not only increased the range that ticks occupy, but they have also increased the developmental rate of ticks—meaning more and more adult ticks ready and able to spread Lyme disease each and every year. And while provincial and federal governments are finally waking up to the growing problem of Lyme disease, as well as with climate change, such action may be too little, too late. With the catastrophic effects of climate change predicted to start in as little as 22 years, Lyme disease has the potential to become a huge public health crisis in the years to come.
So, where does that leave us? Nowhere good. Lyme disease is a big problem that is only going to get worse, plain and simple. Tackling Lyme disease means tackling climate change—an effort yet to be seen on the scale that’s necessary. And if Nova Scotia and other jurisdictions are telling us they’ve got a handle on Lyme, not only are they lying to us, they’re lying to themselves.
Author: Zachary Weiss
Zach Weiss completed his B.Sc. in Microbiology & Immunology at UBC in Vancouver. Over the years, Zach has become increasingly fascinated with the world of politics and policy, and has spent way more hours listening to political podcasts than he’s willing to admit. As a first-year medical student at Schulich, He’s particularly interested in merging his interest in politics and policy with his growing medical knowledge to advocate for and bring awareness to issues that are often overlooked.