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OVERVIEW

Tick populations are growing across Nova Scotia. The black legged tick, found throughout the province, is known to spread infections, such as Lyme Disease, Human Granulocytic Anaplasmosis (HGA), Babesiosis, and Powassan virus.

Blacklegged ticks survive best in areas that provide a moist habitat and are often found in and near wooded or forested areas, shrubs, long grass, leaf litter, urban parks, and gardens. Adult blacklegged ticks are most active in the spring and fall. They remain active until the temperature is consistently below 4°C. Larvae and nymphs are most active in the spring and summer.

Lyme disease is considered established in Nova Scotia, meaning it’s not expected to go away, and rates of anaplasmosis are increasing.  Sporadic cases of babesiosis have been reported. No human cases of Powassan virus have been identified.

Lyme Disease

Lyme disease is a bacterial infection transmitted to humans by a bite from an infected blacklegged tick. In Nova Scotia, only the blacklegged tick carries the bacteria that causes Lyme disease, and not all blacklegged ticks carry the bacteria.

Ticks attach to the skin and feed on blood. In most cases, a tick carrying the bacteria that can cause Lyme disease must attach and feed for at least 24 hours, often 36-48 hours of attachment before the bacteria can be transmitted.

Lyme disease cannot be transmitted by touching, kissing or being near an infected person.

Primary care providers and pharmacists can assess the risk and prescribe an antibiotic for the prevention of Lyme disease. Learn more at: https://novascotia.ca/dhw/pharmacare/healthcare-services.asp

Where are the areas of risk for Lyme disease in Nova Scotia?

Blacklegged ticks are found throughout Nova Scotia and all areas of the province are considered as higher risk of Lyme disease.  Within all areas of the province, blacklegged ticks are found in long grass, leaf litter, shrubs, woody areas, urban parks, and gardens.

What should you do if you think you have Lyme disease?

Tick bites are often painless, and you may not know that you have been bitten. Symptoms for Lyme disease typically appear 3 to 30 days after you have been bitten and may include any of the following:

• Rash (sometimes shaped like a bull’s eye)
• Fever
• Chills
• Headache
• Fatigue
• Aching muscles and joints
• Swollen lymph nodes

More severe symptoms (experienced weeks to months after a tick bite and no antibiotic treatment taken) may include but are not limited to:

• Severe headaches
• New skin rashes
• Facial paralysis (such as Bell’s palsy)
• Irregular heartbeat
• Joint pain
• Nervous system disorders (such as dizziness, confusion, or inability to think clearly, and memory loss, nerve pain, numbness or tingling in the hands or feet)

If you have recently been in a grassy or wooded area and have symptoms suggestive of Lyme disease, especially if they include a bull’s eye rash, you should seek prompt medical attention. Effective May 1st, 2024, pharmacists have been authorized to assess and prescribe treatment of early Lyme disease as outlined by the Infectious Disease Expert Group. This will increase accessibility for individuals who meet the criteria for prevention and treatment of Lyme disease.

Lyme Disease PEI:

PEI is considered a low risk area for Lyme disease. It is possible to encounter a blacklegged tick infected with the Lyme bacteria so it is important to follow prevention measures.  For more information, please visit: https://www.princeedwardisland.ca/en/information/health-and-wellness/lyme-disease-in-pei

Human Granulocytic Anaplasmosis (HGA)

Human Granulocytic Anaplasmosis, often referred to as anaplasmosis, is a bacterial infection transmitted to humans by the bite of an infected blacklegged tick. In recent years, there has been an increase of laboratory confirmed reports of anaplasmosis in NS.

What are the symptoms of anaplasmosis?

Anaplasmosis symptoms generally appear 5 – 21 days following the bite of an infected blacklegged tick. The first symptom is typically fever, followed by one or more of the common symptoms including:

• chills,
• headache,
• muscle aches and
• joint pain.

Most cases are mild and self-limiting with all symptoms typically resolving within most patients within 30 days however, severe illness is possible.  The risk of anaplasmosis infection can be lowered by preventing tick bites and illness can be successfully treated with antibiotics.

Co-infection with other tick borne diseases such as Lyme disease is possible.

Babesiosis

Babesiosis is caused by a parasite spread to humans by the bite of an infected black legged tick. There has been sporadic human laboratory confirmed reports of babesiosis in Nova Scotia over the last several years. 

Some people infected with babesiosis have mild symptoms or don’t experience any symptoms at all. Babesiosis may cause a more severe infection for individuals who have compromised immune systems including older adults, and individuals who do not have a spleen or have serious liver or kidney disease.

What are the symptoms of babesiosis?

Babesiosis symptoms usually appear within 1-4 weeks following a bite from an infected blacklegged tick. Symptoms experienced can include:

• Fever, chills
• Sweats
• Headache
• Body aches
• Loss of appetite
• Nausea
• Fatigue

Powassan Virus Infection

Powassan virus infection is a viral infection spread to humans through the bite from an infected tick. Three types of ticks can spread Powassan virus, the blacklegged tick, the groundhog tick, and the squirrel tick; the blacklegged tick is the most common species of these ticks found in Nova Scotia. Powassan virus has been identified very sporadically in ticks found in Nova Scotia.  No laboratory confirmed human cases have been reported.

What are the symptoms of Powassan Virus Infection?

Many people who have Powassan virus infection are asymptomatic, showing no symptoms. For people with symptoms, the time between when they were bitten by the infected tick to the feeling sick can range from 7 – 34 days. Initially, people can experience mild Influenza-type symptoms, most commonly headache and fever. Powassan virus infection can cause severe disease such as viral meningitis or encephalitis.  Approximately 10% of neuro-invasive disease cases are fatal and survivors may have long lasting effects.

If you have recently been in a grassy or wooded area and have symptoms suggestive of tick borne disease, you should seek advice from your health care provider.

For more information on reducing your risk of tick borne illness and removing ticks, please visit the health topic Tick Safety

FOR MORE INFORMATION

Nova Scotia Department of Health Tick Borne Diseases:

https://novascotia.ca/dhw/cdpc/lyme.asp

Nova Scotia Government Tick Safety:

https://novascotia.ca/ticksafety/