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Infectious Diseases

Lyme Disease and Ticks

If you spend time outdoors in forests and wooded areas or areas with shrubs, tall grass, and leaf litter for work or play, you should be aware of ticks and Lyme disease. Lyme disease can be serious, but preventable illness. You can protect yourself and your family by knowing the risks of tick bites and Lyme disease, how to prevent them, and what to do if you find a tick, get bit, or get sick.

The role of the Simcoe Muskoka District Health Unit (SMDHU) is to reduce public risk to vector-borne diseases like Lyme disease by providing education and monitoring for the presence of ticks (vectors) of public health concern.

On this page you will find information and resources about ticks, Lyme disease, and prevention measures to reduce the risk of tick bites and Lyme disease.

NEW: Tick-Talk: Full Body Tick Check

Doing a full body tick check is an easy and effective way to protect yourself and your family from Lyme disease. Watch this short video to learn how to do a full body tick check! 

 

The video is also available in French.

Lyme disease is caused by the bacterium Borrelia burgdorferi. Lyme disease is a tick-borne disease transmitted to humans (and pets) through a bite of an infected blacklegged tick.

Not all ticks carry the bacteria that causes Lyme disease so not all tick bites will cause Lyme disease. However, it may only take one bite from an infected tick to make you sick. An infected blacklegged tick needs to attach/feed for at least 24 hours to transmit Lyme disease to a person. You cannot tell if a tick is infected with the bacteria that causes Lyme disease just by looking at it, therefore treat all blacklegged ticks the same. Lyme disease does not spread from person to person.

Lyme disease can be effectively treated in its early stages (when the first set of symptoms appear) and often medication can be taken after a tick bite to prevent symptoms from starting. If Lyme disease is left untreated, more sever, longstanding symptoms and complications may occur.

Tick habitat and local risk of Lyme disease is expanding in Ontario due to the pressures of climate change. Blacklegged ticks are present in Simcoe Muskoka and locally, acquired blacklegged ticks have tested positive for the bacteria that causes Lyme disease.

The type of symptoms and the severity of those symptoms vary from person to person. This can make diagnosis of Lyme disease a challenge.

Early symptoms of Lyme disease usually begin within 3 to 30 days after being bitten by an infected tick. Most people experience flu-like symptoms in the early stages. Some people will not experience symptoms until several weeks after a bite.

Symptoms of Lyme disease can include one or more of the following:

  • Skin rash, sometimes shaped like a bull's eye that gets bigger over time
  • Fever
  • Chills
  • Fatigue
  • Headaches
  • Stiff neck
  • Muscle aches, joint pain
  • Swollen lymph nodes
  • Spasms, numbness, or tingling
  • Facial paralysis

Contact a health care provider if you:

  • Have been bitten by a blacklegged tick. Talk to your health care provider about when you were bitten, how long the tick was attached, and where you might have picked up the tick. This information can help your health care provider assess the risk of Lyme disease.
  • Become ill with these symptoms or if you feel unwell within 30 days of a suspected tick bite.

Most cases of Lyme disease can be successfully treated during the early stages (when the first set of symptoms appear). More severe symptoms including recurring arthritis, neurological problems, and heart disorders can occur if left untreated. These symptoms can be longstanding and cause additional health complications.

For more information about Lyme disease symptoms, refer to Health Canada's website.

If you get bit by a tick, use eTick to identify the tick species. If eTick identifies the tick as a blacklegged (Ixodes scapularis) tick, please contact your health care provider as soon as possible as there can be medication that may prevent symptoms from developing.

It is important to seek medical attention if you develop symptoms within 30 days of a suspected tick bite. Based on the health care provider's assessment, an antibiotic may be prescribed. If treated early with appropriate antibiotics, people can expect to make a full recovery.

If the initial infection is not treated, the infection can become difficult to treat and patients may experience joint, heart, and neurological symptoms.

For more information on Lyme disease treatment, refer to Health Canada's website.

In Ontario, Lyme disease is transmitted by an infected blacklegged (Ixodes scapularis) tick.

Blacklegged ticks are present in Simcoe Muskoka and locally, acquired blacklegged ticks have tested positive for the bacteria that causes Lyme disease.

Ticks cannot jump of fly. When a person or animal brushes by vegetation (such as grass or shrubs along a forest trail) that the tick is resting on, the tick climbs onto the person or animal in search of a place to bite and feed (exposed skin).

Just like mosquitoes, ticks survive on blood. They insert their mouthpart into the skin of a person or an animal to feed. An infected tick can spread the bacteria that causes Lyme disease to humans when they feed; however, in most cases, they need to be attached for at least 24 hours before the bacteria will be transmitted. Ticks are small and bites are usually painless which means without checking, you might not know that you have been bitten. It is important to check for and remove ticks as soon as possible to prevent Lyme disease.

What do blacklegged ticks look like?

Blacklegged ticks are small. They range in size from a poppy seed to a pea (1-5 mm). A tick's size depends on its life stage (larva, nymph, adult), whether it has fed recently, and how long it has fed. If a tick has been attached to the skin for a few days, it can swell and appear brown or grey. If a swollen tick is on your skin, it may appear as a new skin tag or pimple.

The images below show how a blacklegged tick nymph (Figure 1) and adult-female (Figure 2) appear the longer they feed. 

Figure 1: Nymph-Stage: Blacklegged Tick Growth

Image Source: URI TickEncounter Resource Center


Figure 2: Female Adult-Stage: Blacklegged Tick Growth
Image Source: URI TickEncounter Resource Center

Where are blacklegged ticks found?

The risk of being exposed to a blacklegged tick is highest in forests, wooded areas, and places with shrubs/bushes, tall grass, and leaf litter. Trails surrounded by mixed vegetation and the edges of these areas are also common areas where blacklegged ticks have been found. If you work outdoors or participate in outdoor activities (such as hiking, biking, fishing, camping, hunting, golfing), you may be at risk for a tick bite. Ticks are most active in the spring, summer, and fall.

In Ontario, a map of estimated Lyme disease risk areas is updated each year. This map identifies areas in Ontario where blacklegged ticks have been consistently found based on tick dragging (active surveillance). It is important to recognize that although this map identifies known risk areas, there is a chance of being exposed to an infected blacklegged tick anywhere in Ontario.

Avoiding tick bites and early detection and removal of ticks quickly after a tick bite can effectively prevent Lyme disease and other tick-borne illnesses.

Full body tick check:

Do a full body tick check on yourself and your family (including pets) after being outdoors as soon as you can and at least before you go to bed that day. Remind friends who were with you to do the same. It is an easy and effective way to protect yourself and your family from Lyme disease. Removing a tick within 24 hours can prevent infection. A convenient time to do a full body tick check is while you shower/bathe or get into your pajamas. Learn how to do a full body tick check by following these steps:

  • Remove your clothes.
  • Check your entire body for ticks, starting from your head down to your toes.
  • Remember to check the common tick hiding spots:

    -  Hairline on your neck
    -  In and behind your ears
    -  Underarms
    -  Back
    -  Chest
    -  Waist and bellybutton
    -  Groin and buttocks
    -  Front and back legs
    -  Between your toes

  • For places on your body that are hard to see, use a mirror or ask someone else to check for you.
  • If you find a tick, remove it as soon as possible following the instructions below. Save the tick in a sealed container for identification.
  • If you find a remove one tick, remember to check the rest of your body. If there is one, there is a good chance there are more.

Watch the 'Tick Talk: Full Body Tick Check' video. The video is also available in French.

Reduce your exposure to ticks:

  • Dress smart:

    -  Wear light-coloured clothing to make ticks easier to spot.
    -  Wear long-sleeve shirts, pants, and closed-toe footwear. Tuck your shirt into your pants and tuck your pants into your socks. This can help prevent ticks from crawling onto your skin where they can feed.
    -  Permethrin-treated clothing may provide protection against ticks and mosquitoes.

  • To deter ticks, use an insect repellent with DEET or Icaridin when outdoors where ticks may be active. Apply the repellent according to the manufacturer's instructions.
  • If possible, stay on the trails when walking or biking in the woods and other natural areas.
  • Take a shower as soon as you can after being outdoors to wash off any loose ticks before they bite.
  • Put your clothes in the dryer on high heat for 15-20 minutes before washing them. This will kill any ticks that might be on your clothing.

If you find a tick on the body, remove it as soon as possible. Removing a tick within 24 hours reduces the risk of Lyme disease infection.

Follow these steps to remove a tick:

  • Use clean, fine-tipped tweezers to carefully grasp the tick as close to the skin as possible. Avoid squishing or squeezing the tick's body. This can cause the Lyme disease-causing bacterium to be accidentally introduced into the body.

    -  Do not try to burn the tick or put anything on the tick in efforts to remove it. 
    -  Do not use your fingers to remove an attached tick.

  • Pull the tick straight-up with firm and even pressure. Take your time; there may be resistance.

    -  Do not twist or yank while pulling the tick out; this can cause the mouthpart to break off and remain in the skin.
    -  If part of the tick remains in the skin, remove it with tweezers. If you are unable to remove it easily, leave it alone to let the skin heal.

  • Once the tick is removed, clean the bite areas and your hands with soap and water and/or rubbing alcohol.
  • Save the removed tick in a sealed container (e.g. bottle or jar with a lid) for identification.

If you are uncomfortable removing a tick or cannot remove the tick because it has buried itself deep into the skin, seek assistance from your health care provider.

After removing the tick, use eTick.ca for tick identification and contact your health care provider to help assess your risk of Lyme disease. This is especially important if the tick has been attached for 24 hours or more, or if you are unsure how long the tick has been attached. The more swollen a tick is, the longer it was likely attached.

The purpose of tick identification is to gather information about ticks and assess the risk they pose to the public across Ontario. Tick identification can help health care providers make an assessment for your health and contribute to public health surveillance of local tick populations.

NEW: SMDHU is no longer accepting tick submissions from the public for tick identification. Instead, please use eTick.ca to identify the tick you found.

eTick

eTick is a free public platform for image-based tick identification and monitoring of ticks in Canada, led by Bishop's University. The eTick platform provides timely and accurate tick identification information to help you and your health care provider assess your risk of Lyme disease.

Photos of ticks found on humans and animals can be sent to eTick. eTick will identify the tick species. You can access the platform on their website at eTick.ca (best viewed with Chrome, Safari, or Firefox) or download the free eTick app (available for Androids and iPhones).

If eTick identifies the tick as a blacklegged (Ixodes scapularis) tick, please contact your health care provider, especially if you feel unwell. Your health care provider will identify next steps to take, if any, for your health.

SMDHU monitors tick populations and human cases of Lyme disease in Simcoe and Muskoka.

SMDHU does tick dragging to actively look for blacklegged ticks. Tick dragging is a standardized method of active surveillance used in Ontario. Ticks found are identified and tested for tick-borne diseases, including Lyme disease. SMDHU typically conducts active surveillance in spring and fall.

Prior to the COVID-19 pandemic, the SMDHU also accepted ticks submitted from the public for identification. SMDHU is no longer accepting ticks for submissions. Instead, people are encouraged to use eTick.ca to identify their ticks. eTick is a citizen science initiative where the public can participate in monitoring tick populations by submitting a tick photo to eTick.ca for professional identification. Data collected by eTick through digital submissions by people like you, will support SMDHU's surveillance of the local tick populations.

Human cases of Lyme disease are reported to Ontario Public Health and monitored.

NEW: Bacterial testing for blacklegged ticks

The Public Health Agency of Canada's National Microbiology Laboratory (NML) has stopped testing blacklegged ticks found by the public for the bacteria that causes Lyme disease. As such, public health units, including SMDHU and health care providers, will no longer send ticks found by the public to the NML for bacterial testing. The bacterial testing was for surveillance purposes only and not to diagnose Lyme disease in humans. Therefore, the discontinuation of this program will not impact individuals care or treatment by a health care provider should they be bitten by a blacklegged tick.

Data collected by eTick, in addition to tick dragging done by SMDHU, will continue to support SMDHU's surveillance of local tick populations.

Our HealthSTATS website has more information about tick surveillance and Lyme disease surveillance. There is a map of tick locations available on eTick.ca.

Here are some tips to make your environment less tick friendly:

  • Keep grass mowed and trimmed.
  • Remove leaf litter, brush, and weeds from the edge of the lawn, around stonewalls and woodpiles, and from lawn ornaments (e.g. wheelbarrow, play structures, statues, gutters, etc.).
  • Move woodpiles and bird feeders away from the house.
  • Move children's play structures (swing set, sandboxes) and patios away from property edges with overgrown areas or forests.
  • Use woodchips or stone to separate forested, overgrown areas and tall grass from the rest of your lawn.
  • Discourage deer, rodents, and birds from your yard through the use of barriers (i.e. BBQ, bird feeders, etc.). Ticks feed on deer, rodents, and birds, and can be carried into your property by these animals.

Climate change connection

Our climate is changing, and these changes are affecting human health and wellbeing in Simcoe Muskoka, including infectious diseases transmitted by ticks and mosquitoes (also known as vector-borne diseases) like Lyme disease. Climate change, particularly increasing temperatures, creates more tick-friendly environments and longer seasons where ticks are active. Climate change is driving the rapid expansion of blacklegged ticks across Ontario and within Simcoe Muskoka.

Climate change mitigation and adaptation will combat climate change and reduce the risks of Lyme disease and other climate-health risks. SMDHU is engaged in a number of strategies to help our community adapt to the changing climate-health risks. This includes surveillance, increasing awareness, encouraging prevention measures, and working with community and health care partners.

For more information and resources on climate-related health risks visit:

Other tick-borne diseases

Powassan virus, Anaplasmosis, Babesiosis, and Borrelia miyamotoi disease are other tick-borne diseases that can be transmitted through the bite of an infected tick. In Ontario, the risk for these other tick-borne diseases is low.

Public Health Ontario and the Public Health Agency of Canada monitors to see if ticks are carrying and transmitting other tick-borne diseases such as those listed above.

If you are travelling locally within Ontario, Canada, or beyond, there is a chance that you may come into contact with different types of ticks and tick-borne diseases. If you have questions or concerns about tick-borne diseases, it is important to speak with your health care provider.

Powassan virus (POW) is a rare tick-borne disease spread to humans or animals through an infected tick. Three types of ticks are known to transmit Powassan virus in Canada: squirrel tick, groundhog tick, blacklegged tick. You can learn more about the Powassan virus from Health Canada.
Anaplasmosis is a rare tick-borne disease spread by blacklegged and western blacklegged ticks infected with Anaplasma phagocytophilum. You can learn more about Anaplasmosis from the Centres for Disease Control and Prevention.
Blacklegged ticks infected with Babesia microti can cause Babesiosis. Babesiosis is a tick-borne disease that can infect red blood cells. You can learn more about Babesiosis from the Centres for Disease Control and Prevention.
Blacklegged ticks infected with Borrelia miyamotoi can also cause illness. This is an emerging disease and infection is currently rare. You can learn more about Borrelia miyamotoi disease from the Centres of Disease Control and Prevention.
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