A new petition is calling on the provincial government to act on concerns about tick-borne infections in Nova Scotia.
The Nova Scotia Lyme Advocacy Group — which works to raise awareness about the need to educate the public and medical professionals on prevention and treatment of Lyme disease — initially prepared a petition for submission to the Nova Scotia Legislature in 2020.
While the onset of the pandemic halted those plans, the petition has now been updated and re-launched with the title ‘Tick-Borne Diseases in Nova Scotia – Diagnosis, Treatment, Awareness Requirements.’
“It was in 2014 that (we held) the first Lyme support group meeting in Bedford. And some of those people that were at that meeting are still struggling,” Lyme disease advocate and survivor Donna Lugar said in an interview.
“That was a long time ago, 10 years ago. And there are people still struggling because they were not diagnosed early enough. They were not treated properly. And, myself included, we still have a significant amount of symptoms.”
Lugar’s group is urging the government to act on three requests presented to the PC caucus in early 2022. Those include: more education for health care providers and residents; a non-partisan task force that includes people with lived experience; and a tick-borne diseases clinic.
Lugar said during that 2022 conversation with the PC Caucus, Premier Tim Houston indicated that the group’s requests “weren’t unreasonable.”
Can’t take precautions if you’re unaware of the problem
The new petition also calls on the province to implement a year-round awareness campaign so Nova Scotians and visitors to the province are more tick aware. In addition, advocates are requesting a disclaimer be added to the province’s clinical care guidelines for tick-borne diseases.
“It’s amazing to me how many people, even here in Nova Scotia, don’t really give them (ticks) much thought, don’t think there’s much concern there. If they do think about it, they may think it’s something minor and not a huge concern. There’s a lot of people going without an early diagnosis,” Lugar said.
“First of all, because the ticks are small you don’t tend to see them. Even if you do a tick check, you might miss them because they go to warm, moist areas and they don’t hurt generally when they bite. And they drop off. I’m not going to say nine times out of 10, but a lot of times you would never know that a tick bit you.”
In addition to public awareness campaigns targeting tourists coming to the province, Lugar said it’s critical to ensure more Nova Scotians — especially newcomers — are educated about ticks and tick-borne diseases.
“And if you worry about impacting tourism (through a campaign), well, if you’ve got tourists coming in and they take ticks or Lyme disease home with them and they are vocal about it, you’re going to severely impact tourism,” she said.
“All you have to do is say ‘Here are the precautions, here’s how you should properly remove a tick, and have fun.’ But you have to be aware that it’s here.”
‘It’s not just Lyme anymore’
The petition also highlights the need for a provincial clinic dedicated to tick-borne diseases. Lugar points to Manitoba’s tick collaborative care service as an example.
That service was developed as a result of what Manitoba described as the “increasing burden and challenges associated with diagnosing and managing cases of possible late Lyme and/or other emerging tick borne diseases.”
The Manitoba clinic’s services are designed to do the following:
- Streamline, coordinate and improve the care of this patient population
- Enhance collaboration between primary care and specialists
- Serve as a support and educational resource for primary care providers caring for this patient population
“We haven’t really seen a lot of more forward movement. We really need a dedicated clinic…A dedicated Lyme and tick-borne diseases clinic, we have to be very specific. It’s not just Lyme anymore,” Lugar said.
“That’s needed because we’re still being told by people that their doctors are saying, ‘Well, I don’t really know much about it.’ We’ve got people struggling for weeks, months, years and not getting a definitive diagnosis.”
Lugar said she regularly hears from Nova Scotians who had no idea Lyme disease could be serious. Many are also surprised to learn they can be bitten and not get the ‘bull’s eye’ rash most often associated with Lyme disease.
“It’s a fairly recent development in the research world that it’s not just the bull’s eye rash. There’s many more types,” Lugar said. “The CDC (Centers for Disease Control and Prevention) put out a poster last year showing the many forms of Lyme disease rashes.”
Images of other Lyme disease rash presentations besides the classic bull’s eye can be found here.
Seven year old just diagnosed with Lyme arthritis
A tick-borne disease caused by the bacterium Borrelia burgdorferi, Lyme disease can be transmitted to humans by the tiny nymphs and adult females of black-legged (deer) ticks, which feed on various mammal and avian hosts. These include deer, rodents, and ground-foraging birds.
“There’s a lot of misinformation out there. People just think it’s not that big of a deal and ‘I’ll absolutely see a tick if it’s on me,’ or ‘I didn’t feel a tick bite. I didn’t see a rash,’” Lugar said. “Personally, I think there’s thousands of people in Nova Scotia struggling with Lyme and tick-borne diseases. Many of them have no idea.”
Without proper treatment, Lyme disease can begin to significantly impact a person’s health as the bacteria spreads through the body and multiples.
“We get emails and calls about this daily. I have a Lyme support group meeting once a month…Just at our last meeting (earlier this month), we had two new people,” Lugar said.
“One was a mom with three small kids. One was a mom and her seven year old daughter who had just been diagnosed with Lyme arthritis. And both of them weren’t diagnosed early. This is still a huge issue.”
Lyme arthritis is a result of Lyme disease bacteria entering joint tissue.
Almost four times higher than national rate
In a July 2021 Examiner article by Joan Baxter, Dr. Vett Lloyd explained what can happen if someone doesn’t receive the right treatment for Lyme Disease. The Mount Allison University biology professor is also principal researcher at the Lloyd Tick Lab:
The bacteria…can invade organs. Some organs can tolerate them. So if they end up in your joints, that’s going to cause inflammation. Pain makes your life miserable but it probably won’t kill you. If they end up in your heart and you get inflammation there, that’s a much worse outcome. That leads to something called Lyme carditis, which is basically inflammation of the heart due to Lyme disease. That’s fatal.
The bacteria can also impact the liver, she said, adding:
Very well studied in Europe and much less so here is neuroborreliosis. This cheerful medical term basically means the Lyme disease bacteria get into the brain and that’s going to cause inflammation and all kinds of bad things. You don’t actually want bacteria in your brain. That can lead to slower forms of neuro-degeneration, which contributes to death.
Nova Scotia has the highest per capita incidence of Lyme disease in the country.
The province’s most recent notifiable diseases surveillance report from 2022 logged 310 confirmed cases of Lyme disease, with a rate of 30.4 cases per 100,000 population in 2022.
As the report noted, Nova Scotia’s confirmed case rate of Lyme disease was almost four times higher than the Canadian rate in 2021 (7.7 cases per 100,000).
Data under-represent ‘true burden of disease’
The report also included a caveat that the data “should be interpreted with caution” because the COVID-19 pandemic impacted public health capacity. As a result, there were 1,078 positive lab results of Lyme disease in 2022 that weren’t entered into the database.
Because data from 2020-2022 weren’t consistently entered into Panorama and were not validated, the surveillance report noted that the data “therefore under-represent the true burden of disease.”
The Nova Scotia Legislature doesn’t permit electronic petitions. They must all have original signatures, and each page must include the petition’s full wording. Due to the length of the tick-borne diseases petition, only five signatures per page are possible.
Lugar said it’s going to take time to get a robust collection of signatures, and that’s why the group plans to present it during the fall sitting of the legislature rather than sooner.
“We’re going to use the whole summer, because there are markets and all these different things that people can sit at and obtain the signatures,” she said. “And we will have to find an MLA or two or three willing to table it.”
Need for significant change
Despite the challenges involved with collecting a large number of original signatures, Lugar is confident they’ll receive help from supporters willing to go door to door, to share with friends and family, and attend local markets and events. She also anticipates assistance from local businesses and others.
Although it can’t be presented in the legislature, Lugar also just launched an online petition to help drum up more attention for the cause. She encourages anyone interested in collecting signatures for the hard copy petition to contact her here to receive a copy that can be printed off.
“I get very frustrated because I’ve been at this for a long time, and there’s other people at this for a long time,” Lugar said. “And by now we should be seeing some significant change, and we’re just not seeing it.”
Expansion of tick season
There’s also concern about the impact of the climate crisis on the province’s tick population.
In an article published in the journal Insect Science last May, Dalhousie University researchers found that female deer ticks infected with the pathogen that causes Lyme disease are more likely to survive the winter than their uninfected female counterparts.
An increased ability to survive winters could not only increase the tick population, but also lead to an expansion of their range even farther north.
In a 2019 federal report titled ‘Increased risk of tick-borne diseases with climate and environmental changes,’ researchers noted that a warming climate and other environmental changes have contributed to an expanded range of several tick species into Canada:
As temperatures increase in Canada, the environment becomes more suitable for ticks and the season suitable for tick activity lengthens, so tick-borne diseases are likely to become more common in Canada.
In addition to Lyme disease, four other tick-borne diseases (TBDs) have started to emerge and are likely to increase: Anaplasmosis; Babesiosis; Powassan virus; and Borrelia miyamotoi disease.
Increased temperature increases the survival and activity period of ticks, increases the range of both reservoir and tick hosts (e.g. mice and deer) and increases the duration of the season when people may be exposed to ticks. Other ticks and TBDs may spread into Canada as the climate changes.
Last week, Nova Scotia-based meteorologist Cindy Day told her subscribers that “this past winter was the warmest winter in Canada in 77 years,” adding “climate change for sure.”
Public awareness campaign being finalized
In an emailed statement, a spokesperson with the Department of Health and Wellness said the department provides the public with awareness and educational information annually during peak tick season.
Khalehla Perrault wrote that although this year’s plan is still being finalized, there’s a web page available year-round. Perrault also noted that last year, the department worked with the Department of Natural Resources and Renewables (DNRR) to have “informational and awareness signs produced for each operational provincial park.”
She said DNRR staff are working on getting them posted, adding:
With the warmer weather approaching, ticks will start to appear, and it’s important that people take precautions to prevent tick exposure when outdoors. Tick-borne illnesses such as Lyme disease, Anaplasmosis, Babesiosis and Powassan virus infection are preventable by taking some simple precautions.
Some precautions include tucking in shirts, pulling socks over pant legs, and checking for ticks after being outdoors. There is a lot of great information about how to enjoy the outdoors and protect against tick bites on our webpage https://novascotia.ca/ticksafety/ .
Perrault said people can also turn to local pharmacies for early protection against Lyme disease, where pharmacists can assess a tick bite and determine if a preventative antibiotic is appropriate. More information on that can be found here.
If you are out and about just about anywhere one must assume there are ticks present. Pants tucked in socks just for a walk about town. For any yard work I wear one of those hooded cover all things zipped up tight. Looks freakish, but I am a freak and I don’t care. Better than lyme – nasty, nasty disease. Strip it off carefully and never reuse – into the garbage with the elbow high rubber gloves. My rubber boots I keep in a sealed rubbermaid container for next time.
Nova Scotia is undergoing a paradigm shift in terms of tick prevalence. Growing up in NS, ticks were the domain of more rural fields and woods. But, as we have so effectively been destroying their preferred habitats, wildlife has become regulars in suburban and urban areas. So, a cute deer, raccoon, bunny, etc in your backyard brings the possibility that it carries ticks that may drop off in your yard to complete the next cycle of its life. Then, your children or pets are subsequently romping “safely” in the yard….but are they safe? Last Spring, vets spoke about the large increase in Lyme disease numbers that they were seeing over previous years. Well, if critters are getting bit, I would bet that children are as well. And, since most are predispositioned to think their children are safe in the yard, they may not notice that they are bitten or are being bitten. Life with Lyme or even battling an infection short-term is no joke. Generally, we in NS remain less aware of tick infiltration into where we live than we should arguably be. Thank you for bringing awareness to your readership.