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Lyme disease alert

Blacklegged ticks out in southern Manitoba

blacklegged tick nymph
Blacklegged ticks can be as small as a poppy seed.
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Identifying blacklegged ticks

Protect yourself from ticks

Map of locations where blacklegged ticks are found in Manitoba

Rising challenge of Lyme disease

More on Lyme disease

More on HGA

BY SUSIE STRACHAN
Winnipeg Health Region
Published Friday, May 25, 2012

See the little speck on the fingernail in the photo above? That's a blacklegged tick nymph. Between a mere 1 to 5 mm in size, these ticks are incredibly hard to see, yet they're something you have to keep an eye out for.

In Manitoba, both nymph and adult blacklegged ticks can carry the bacteria that cause Lyme disease and anaplasmosis. Different from the more common American dog tick, blacklegged ticks are being found in a number of areas across the southern part of Manitoba.

This has prompted Manitoba Health to warn everyone to take precautions in order to avoid exposure to Lyme disease.

"Look for blacklegged ticks after you've been in habitat they live in," said Susan Roberecki, the Medical Lead with Environmental Health Public Health and Primary Health Care Division of Manitoba Health. "You want to take a good look at your skin and remove any attached ticks. Taking a shower or a bath after returning home after being outdoors is a good way to look at your skin."

The risk of getting a tick-borne disease is small, especially if the tick is removed soon after it becomes attached. But your chance of getting Lyme disease in Manitoba is increasing, especially if you frequent areas where blacklegged ticks are established.

Blacklegged ticks are different than the more common American dog tick, which poses little if any threat to human health in Canada (click here for the difference between the ticks).

"People should consider taking precautions because the ticks are out there," said Roberecki, adding that transmission usually does not occur until the tick has been attached for 24 to 48 hours so daily tick checks can be very beneficial to prevent infection. 

Since 2009, 28 human cases of confirmed and probable Lyme disease from blacklegged ticks have been identified in Manitoba.

In 2011, Manitoba had seven confirmed cases of Lyme disease and four probable cases. Four additional reports not meeting the national surveillance case definition were also received. The definition for confirmed and probable cases for surveillance purposes is more stringent than clinical criteria used by physicians to consider treatment for Lyme disease. More patients are treated for Lyme disease than are reported to Manitoba Health. 

"Early cases of Lyme disease are diagnosed and treated by physicians based on the patient's history and symptoms. Laboratory tests usually do not become positive until later in the illness," said Roberecki.

Symptoms of Lyme disease can start about three days to one month after a tick bite, often with an expanding circular rash around the site of the bite, which then fades. Early symptoms can also include headache, stiff neck, fever, muscle aches or fatigue, chills and swollen lymph nodes.

"An indicator is the red rash, five centimetres or larger, usually at the site of the tick bite. Sometimes, it's in the shape of a bull's eye," she said. "Not everyone develops or notices the rash, so it's also important to be alert for other possible symptoms of Lyme disease - fever, headache, chills, fatigue, sore throat, a stiff neck, and pain in the muscles or joints - especially if you've spent time in 'tick country' during the past month."

Lyme disease can be successfully treated with antibiotics. Treatment is most successful in the early stages of infection. Talk to your doctor if you think you have Lyme disease.

Approximately one to two per cent of the blacklegged ticks submitted as part of the tick surveillance program in Manitoba were infected with bacteria that causes human granulocytic anaplasmosis (HGA or anaplasmosis for short).

In most cases, HGA is a mild illness. Some people can get seriously ill, particularly people who are immune compromised or have other health conditions affecting the immune system. Rare severe complications can include respiratory or kidney problems, encephalitis or meningitis, blood clotting disorders and occasionally death.

The symptoms of HGA can include fever, chills, headache, muscle aches and nausea. Less frequent symptoms can include vomiting, diarrhea, loss of appetite, abdominal pain, joint pain, cough, confusion and occasionally a rash. Symptoms can begin five days to three weeks after being bitten by an infected tick. HGA can be successfully treated with antibiotics.

If you think that you may have Lyme disease or HGA, contact your health-care provider. Early diagnosis and treatment can reduce the time the person is ill and the severity of disease.

For more information, call Health Links-Info Santé at 204-788-8200 (in Winnipeg) or 1-888-315-9257 (toll-free).

Quirky fact

Ötzi the Iceman - a well-preserved natural mummy of a man who lived about 5,300 years ago - was discovered in September, 1991 in the Ötztal Alps near the border of Italy and Austria.

Researchers have analyzed Otzi the Iceman's full nuclear genome sequence, and say he had brown eyes and brown hair, type-O blood, and was lactose-intolerant.

They also discovered that he may have been infected with Lyme disease, thanks to a 60 per cent match of his DNA with that of Borrelia burgdorferi bacterium. If accurate, this would make this infection the earliest-known human case. Experts are hoping to compare the pathogen's genetic material with modern strains, in order to determine how the microorganism has evolved.

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