If you are having any symptoms or have any questions, please call 811 to speak with a registered nurse 24 hours a day.

OVERVIEW

What is Lyme disease?

Lyme disease is a bacterial infection that is spread by ticks.

Lyme disease is carried by black-legged ticks (sometimes called deer ticks).   In Nova Scotia and PEI, only the blacklegged tick carries the bacteria that causes Lyme disease, and not all blacklegged ticks carry the bacteria. These ticks are typically about the size of a sesame seed.

Black legged ticks are found throughout Nova Scotia and all areas of the province are considered as having some risk of Lyme disease.  Although there are areas of the province where the risk of finding blacklegged ticks is higher, there is a chance of finding blacklegged ticks anywhere in the province.  PEI is considered a lower risk area for Lyme disease.

SYMPTOMS

What are the symptoms of Lyme disease?

The symptoms of Lyme disease depend on what stage the disease is in.

Early symptoms (3 to 30 days after tick bite):

• Fever
• Chills
• Headache
• Fatigue
• Joint and muscle aches
• Rash

The rash is a telltale sign of Lyme disease.  This rash usually starts at the site of the tick bite. It expands gradually over a few days.  It can reach up to 30 cm (12 inches) across or more.  The center may fade; creating a “bull’s eye” or target appearance.  The rash may feel warm to the touch.

Some people with Lyme disease do not get the bull’s-eye rash. They may have many red spots instead. Others don’t get a rash at all.

Later symptoms (days to months after tick bite):

If Lyme disease isn’t treated, it can spread to other parts of the body. Late-stage symptoms include

• Headache
• Neck stiffness
• Arthritis (painful, swollen joints)
• Additional rashes
• Facial palsy (face muscles droop)
• Irregular or slow heartbeat
• Numbness in arms or legs
• Inflammation of the brain and spinal cord
• Changes in mood or sleep habits
• Short term memory problems

It is normal to have a small bump or red spot where a tick bit you. This does not mean you have Lyme disease. It usually goes away in a day or two.

CAUSES & RISK FACTORS

What causes Lyme disease?

People get Lyme disease when they are bitten by an infected tick. Ticks live in areas with a lot of plant life, such as wooded areas or fields.  They sit near the top of grassy plants and low bushes.  They wait there for people or animals to brush up against them. Ticks can crawl on your clothes or bodies for up to several hours or more before attaching to the skin.

People who spend time in outdoor areas where ticks are common are at higher risk of getting tick-borne diseases.

DIAGNOSIS & TESTS

How Lyme disease diagnosed?

It can be difficult to diagnose Lyme disease. The ticks that carry it are very small and the bites don’t hurt. Many patients don’t remember being bitten. In addition, most of the symptoms are common with other illnesses.

Blood tests aren’t always necessary to make the diagnosis. They can often give false results, especially in early-stage Lyme disease.

People who have joint swelling or nervous system problems may need to have special tests. Your healthcare provider may need to take some fluid from the swollen joint or the spine to check for clues to your condition.

PREVENTION

Can Lyme disease be prevented or avoided?

The best way to prevent Lyme disease is to avoid being bitten by ticks. When you are outdoors, follow these guidelines:

• Avoid areas that are wooded, brushy, or have tall grass.
• Walk in the center of trails.
• Use tick repellents according to their instructions to help prevent bites. Apply an insect repellent containing DEET or Icaridin to exposed skin or clothes. Permethrin treated clothing repels and kills ticks when they come in contact with it and is now registered for use in Canada for those age 16 and older.
• Wear light-colored clothing, long-sleeved shirts and pants, and closed toed shoes.   Tuck shirts into pants and tuck pant legs into your socks.

After you get home, check everything and everyone for ticks.

• When possible, take a bath or shower within two hours of being outdoors. This makes it easier to find ticks and washes away unattached ones
• Check clothing and inspect skin including in and around ears, arm pits, inside belly button, groin, around the waist, and especially in hair and scalp area
• Check any gear you used, including coats, backpacks, or tents.
• Put clean and dry outdoor clothes in a dryer on high heat for at least 10 minutes to kill any remaining ticks

TREATMENT

What do I do if I find a tick on my skin?

Don’t panic. Using a pair of fine-tipped tweezers, grasp the tick body as close to your skin as possible. Pull in a steady upward motion until the tick comes out. Be careful not to squeeze or twist the tick body. If any tick parts remain in the skin, you can leave them alone or carefully remove them the same way you would a splinter. Do not use heat (such as a lit match), petroleum jelly, or other methods to try to make the tick “back out” on its own. These methods are not effective.

Wash the area where the tick was attached thoroughly with soap and water or alcohol hand sanitizer. Watch the bite area and the rest of your skin over the few weeks and note any changes.  Make a note of the date and where on the body the bite occurred. This will be important if you, or a loved one, begin to feel unwell.

How is Lyme disease treated?

Lyme disease is treated with antibiotics.

Your healthcare provider will tell you how many days to take the antibiotic. It’s important for you to take all the medicine your healthcare provider prescribes.

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.

FOR MORE INFORMATION

Nova Scotia Department of Health and Wellness website
https://novascotia.ca/dhw/CDPC/lyme.asp

Prince Edward Island Department of Health and Wellness
https://www.princeedwardisland.ca/en/information/health-and-wellness/lyme-disease-in-pei

Public Health Agency of Canada at:
https://www.canada.ca/en/public-health/services/diseases/lyme-disease.html