Monday, June 25, 2012

Lyme Disease

Nova Scotia has an increasing prevalence of Lyme disease. Areas confirmed to have  infected ticks include Yarmouth County, around Shelburne Harbour, around Lunenburg, Bedford, and New Glasgow. However, the public health service does not have the resources to collect ticks for examination from remote areas of the province, like offshore islands. I would regard any tick bite suffered West of Halifax as having a potential to carry Lyme disease, and the department did consider this, but have so far refrained from saying so. The chances of getting Lyme from any one tick bite is low, but the consequences of unrecognised infection are serious. The usual tick you find on yourself is locally called the "American Dog Tick" and is not recognised as a vector for Lyme. They have been present in western Nova Scotia since the earliest decades of the twentieth century.The black legged ticks, locally called "deer ticks", that do carry the disease are much smaller and are often missed. It is said that attachment for more than 24 hours is required to transmit the disease, though as 40% of confirmed cases of Lyme have no definite history of a tick attachment I am a bit circumspect about this. In my experience, all embedded ticks can cause a pretty fierce allergic reaction and local cellulitis requiring antibiotics. Our public health people don't recommend prophylactic treatment, but this is not the practice in places like Cape Cod or rural Connecticut where they have been dealing with this for decades. There, giving 200mg of the antibiotic doxycycline as a single dose for embedded tick attachment is a common practice. Given that access to medical care when you are on a boat in rural Nova Scotia is problematic, you might give this consideration. Should you develop the medical conditions of Bell's Palsy, or inflammatory arthritis, particularly of the knee, within a year of a visit to any undeveloped coastal area west of Halifax ( going for a picnic on an island,for example) you should be tested for Lyme disease. This will not be new stuff for anyone who cruises around Cape Cod or the Elizabeth Islands

1 comment:

  1. Dr. Loveridge,

    Thanks for posting this great blog entry about Lyme disease.

    I certainly appreciate your cheerfully unrepentant political "incorrectness", and I'm sure others do as well.