LYME DISEASE

Carla Booth

Outline

Lyme Disease Hosts and Parasite Life cycle of Borrelia burgdorferi Ticks Where is this Emerging Disease

Recent studies Local responses

History of Lyme Disease

Early 20th century European physicians noticed the slowly growing red rash

1940’s linked rash to multi system illness

1969 successful treatment with penicillin 1970 large number of children with

advanced symptoms (Arthritis) in Lyme Conneticut

1982 Borrelia bacteria identified in association with the rash

1984 conclusive evidence that Borrelia burgdorferi caused LD

1982 started surveillance for LD in North America

Lyme Disease

Infection of human, or animals caused by bacteria Borrelia burgdorferi

Described in Lyme, Conneticut hence it’s name 100, 000 cases since 1982 in North America Some symptoms include:

EM or erythema migrans (bulls eye rash) Fever Fatigue Enlarged lymph nodes Headaches Arthralgia (joint pain) Arthritis Radiculitis (inflammation of spinal nerve root) Cranial nerve palsies

Life Cycle

Note that it can infect multiple hosts (humans, deer, small rodents, birds, ticks, dogs etc)

http://www.textbookofbacteriology.net/Lyme_3.html

Ticks

Recall the tick Dermacentor spp. causes Ghost Moose

The tick that serves as a vector for Lyme Disease (LD) is Ixodes spp. (I. scapularis, I. pacificus)

Hard tick, black legged tick

Black legged Tick

Recent Studies

Plethora of websites claiming emergence of ticks carrying LD, symptoms and preventative measures to be followed

Less scholarly papers/data available ... however Study in United States Study in Eastern Canada (Ontario and

Quebec) Alberta?

Where in North America

Canada: southern and southeastern Quebec, southern and eastern Ontario, southeastern Manitoba, New Brunswick and Nova Scotia as well as much of southern British Columbia.

United states: multiple eastern states, California, Texas, and Florida

The states were ranked in order of highest to lowest number of reported cases

http://www.menstuff.org/issues/byissue/lymedisease.html#rising

United States

Risk Map of US Predicted LD risk in

States 2002 23,763 cases

reported to CDC 95% from Conneticut,

Delaware, Rhode Island, Maine, Maryland, Massachusetts, Minnesota, New Jersey, New Hampshire, New York, Pennsylvania, and Wisconsin http://www.menstuff.org/issues/byissue/

lymedisease.html#rising

Eastern Canada

Study: Vets collected ticks from resident dogs for 1997-1998

Map of Southern Ontario

5.8% infected with B. burgdorferi

Possible spread of infection to places where unifected ticks are established

http://0-web.ebscohost.com.darius.uleth.ca/ehost/pdfviewer/pdfviewer?sid=dd48976a-126f-4d39-b259-c738004a6c34%40sessionmgr11&vid=14&hid=8

Eastern and Central Canada

The spread of LD also due to the expansion of where the vector species of tick (I. scapularis) found

Up to 1997 only confirmed population in Long Point Ontario

Temperature change with global warming is aiding the spread of the tick

Northward migrating land birds as potential mode of expansion

Eastern and Central Canada

http://0-web.ebscohost.com.darius.uleth.ca/ehost/detail?sid=934c4b99-a958-400a-b3ee-003d5687cfda%40sessionmgr11&vid=1&hid=7&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#db=a9h&AN=35703445

Projected spread in the International Journal of Health GeographicsUsed temperature predictions from the CGCM2 climate modelDeveloped an algorithm to predict occurrence in Canada

Eastern and Central Canada

http://0-web.ebscohost.com.darius.uleth.ca/ehost/detail?sid=934c4b99-a958-400a-b3ee-003d5687cfda%40sessionmgr11&vid=1&hid=7&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#db=a9h&AN=35703445 http://0-web.ebscohost.com.darius.uleth.ca/ehost/pdfviewer/pdfviewer?

sid=f37296bd-1f1f-4654-87ef-416e0841fb73%40sessionmgr11&vid=2&hid=8

No. of ticks/human population >0 and >6.11*10-4

6.11*10-4 To 1.761*10-3

1.762 *10-3 to 3.300 *10-

3

3.300 *10-3 to 7.463 *10-

3

7.464 *10-3 to 2.584 *10-

2

2008

1990-2003

Closer to home...?

http://www.srd.alberta.ca/RecreationPublicUse/WildlifeViewing/MedicineHatGrasslandWater/CypressHillsProvincialPark/Default.aspx

http://wildobs.com/place/Cypress-Hills-Provincial-Park-SK

http://insciences.org/article.php?article_id=4568

Potential of spreading infection if established in the white tailed deer population of Cypress Hills

Closer to home

Video clip http://www.ctv.ca/CTVNews/Health/

20100521/lyme-ticks-alberta-100521/

Suggestions made that the adult ticks may have been carried in by migrating birds coming not from the east but from BC

Need more research in the West!

References Banerjee, S. N., Banerjee, M., Fernando, K., Scott, J. D., Mann, R., & Morshed, M. G.

(2000). Presence of spirochete causing Lyme disease, Borrelia burgdorferi, in the blacklegged tick, Ixodes scapularis, in southern Ontario. Canadian Medical Association Journal , 162 (11), 1567-1569.

Bankhead, T., & Chaconas, G. (2007). The role of VlsE antigenic variation in Lyme disease spirochete: persistence through a mechanism that differs from other pathogens. Molecular Microbiology , 65 (6), 1547-1558.

Beware of deer ticks. (2009). Retrieved 03 28, 2011, from Daily Herald Tribune: http://www.dailyheraldtribune.com/ArticleDisplay.aspx?archive=true&e=1293404

Gilmore Jr., R. D., Mbow, L. M., & Stevenson, B. (2001). Analysis of Borrelia burgdorferi gene expression during life cycle phases of the tick vector Ixodes scapularis. Microbes and Infection , 3 (10), 799-808.

Isolation of Borrelia burgdorferi, The Lyme disease spirochete, from rabbit ticks, Haemaphysalis leporispalustris — Alberta . (2011). Retrieved 03 28, 2011, from Canadian Lyme Disease Foundation: http://www.canlyme.com/alberta.html

Lyme Disease. (2011). Retrieved 03 28, 2011, from Government of Alberta:Health and Wellness: http://www.health.alberta.ca/health-info/lyme-disease.html

Lyme's Disease. (1996-2011). Retrieved 03 28, 2011, from Menstuff: http://www.menstuff.org/issues/byissue/lymedisease.html#rising

Odgen, N. H., Lindsay, L. R., Morshed, M., Sockett, P. N., & Artsob, H. (2009). The emergence of Lyme disease in Canada. Canadian Medical Association Journal , 180 (12), 1221-1224.

Odgen, N. H., St. Onge, L., Barker, I. K., Brazeau, S., Bigras-Poulin, M., Charron, D., et al. (2008). Risk maps for range expansion of the Lyme disease vector, Ixodes scapularis, in Canada now and with climate change. International Journal of Health Geographics , 7, 1-15.

Questions