~" B6 Terrace Review — Wednesday, May 30, 1990

Wednesday with Fae

by Fae Mooney

It isn’t just
picnicking bears
you want to watch
out for. The latest
menace in the
woods is as tiny as
a sesame seed —
the woodland tick.

But why?

The reason is
Lyme disease. It’s a
bacterial infection
transmitted by tick
bites.

But is this tiny
insect as much of.a
menace to our
health as recent
reports suggest?
Will every tick bite produce Lyme disease? Is it safe to go out in the
woods?

The long weekend in May usually marks the beginning of the camping
season up here (and camping season generally corresponds with tick
season). A lot of us began spending some of our time enjoying what

If you go ou

) the woodas...

Beware the Lyme-bearing tick

by David Bowering,
Medical Health Officer
Skeena Health Unit

Lyme disease is the most com-
monly reported tick-transmitted
illness in the United States, -Re-
search is now underway to deter-
mine whether it is also a problem
in B.C. and the Northwest.

Lyme disease was first iden-
tified during the investigation of

a cluster of cases of arthritis in’

Lyme, Connecticut in 1975.
Since then we have learned that
it is caused by an organism
called a spirochaete and that
people can get it when they are

| bitten by.certain species of ticks.

One of those species, Ixodes
Pacificus, is common in British

Columbia.
A person who is bitten by an
infected tick may develop a
peculiar migrating rash which
usually fades in three to nine
weeks. When the spirochaete
reaches the rest of the body it
can cause a great variety of
symptoms: fatigue? muscle and
joint pains, headaches, neck
stiffness, and even, paralysis of
facial muscles. In four to eight
percent of-cases the heart can be
involved in the disease and show
abnormalities in electrical’ con-
duction. If the disease is left un-
treated, chronic arthritis and
other less clearl? defined prob-
lems can persist for years.
Antibiotics are effective in

They are “slow-moving creatures, and you may find them in
your clothes before they’ve had a chance to bite,’’ advises the

health bulletin. But if the tick is feeding, remove it immediately.

“Use a small pair of thin-tipped tweezers to grasp the tick, as

treating Lyme disease particular-
ly in the early stages. The longer
it has been present, the more dif-
ficult the treatment.

Is there a test for It?

Yes and no. The test now in
use measures antibodies to the
spirochaete. As we learn more
about this test, we are finding
that it is not specific to the
spirdchaete that causes Lyme
disease. People who have been
exposed to other spirochaetes,
some of which do not cause any
disease at all, may react positive-
ly to the test. To be certain of
the diagnosis, all of the follow-
ing factors must be present:

@ a history of a tick bite in a
locality where ticks are known to
harbor the. Lyme disease
spirochaete

@ characteristic migrating rash
@ typical Lyme disease symp-
toms

@ a positive antibody test.

close to the skin as possible. The tick should then be pulled

straight upward, with steady pressure.’’ Use firm, steady pressure

nature offers (and, hopefully, that excludes encounters with ticks),

is Lyme disease a problem In the Terrace area?

“Tough question,” says Dr. Bowering at the Skeena Health
Unit. There is no simple yes or no answer, Information is still be-
ing gathered, Have there been any confirmed cases of the disease
here? Possible to probable says Dr, Bowering. Those suspected of
having Lyme disease are being treated.

Very few cases have been confirmed in B.C. so far. And no in-
fected ticks have yet been isolated in the province. But that
doesn’t mean there are none — more likely, it’s just that none __
have been found as yet. Of those reported cases in B.C. it has yet ©
to be established whether or not those infected with Lyme disease
were exposed to the disease in or out of the province. Regardless,
the disease does appear to be on the increase.

In fact, in some parts of the U.S. Lyme disease (or LD) seems
to be spreading rapidly. A specialist with the U.S. Center for
Disease Control claims that of cases reported in 1989, statistics
represent only a small fraction. For the most part this is because
of cases going undiagnosed.

How about in Canada? Lyme disease ‘‘remains a serious prob-
lem, but epidemiologists still have not established how wide-
spread it is in Canada’’. This quote comes from the current issue
of Harrowsmith, Confirmed cases of LD have been reported in a
few areas of Canada and the incidents have been increasing.

It is a relatively new health problem to Terrace and not much
information is yet available to the general public. However, if
you are concerned about the disease, a copy of a B.C. Ministry
of Health bulletin on ‘‘Lyme and Other Tick-Borne Diseases’’
can de picked up at the Skeena Health Unit. Outlined in the
bulletin are a brief description and list of symptoms of the
disease and advice on tick removal, disease treatment, and
prevention.

LD is only one of several diseases that can be transmitted
through tick bites, or by the deposit of tick excrement on the
skin.

Not all species of ticks carry Lyme disease. Also — most tick
bites will not spread disease. This is reassuring news.

How do you get a tick bite?

alcohol.’’

likely picked up in.

disease.

parasite and prevent infection.’’

yourself:

tracting blood. ‘‘Although the feeding tick’s mouth will be under
Se the skin, the blood-engorged blue-grey hind parts will be a pro-
- trading bump.”’ Often, but not always, a rash develops at the site
of the bite.

infection.”’

a . How to remove a tick
' .. Ticks are mite-like parasites that can be as small as a pin head.

see your Joctor immediately,

“ Harrowsmith offers this description: ‘‘Ticks spread by lurking
in the grass with their front legs raised in what biologists call a show up clearly
question position’.’’ Trouble begins after a tick hitches onto a .
. cor : . @ tuck pant legs into socks
passing pant leg. ‘Ticks are well equipped to gorge without
discovery.” This is how — ‘‘Their hooked mouthparts cling eer
. . . to licat 1]
tenaciously to animal flesh, and they secrete saliva that contains a application on lower legs)
gluelike cement as well as chemicals that render their bites etc
painless.’? .An average feeding lasts about.four days. ‘‘The e after every venture into the wo
engorged tick, now resembling a blood blisher with legs, drops y
. va .
off its temporary host. _ ‘in the shower is a good idea
What does a tick bite look like?
Because tick bites are often painless they can often go un- tick collar).
noticed. The tick burrows part way into the skin and is easiest to
spot, as stated in the B.C. health bulletin, when it is actually ex-

If you have any doubts, or if you suspect you might have LD,

— and great care. Do not jerk. Do not squeeze the tick’s body.
“This may force germs or tick tissues onto the skin. Once the
tick has been removed, the site can be disinfected with rubbing

As a precaution, it is advisable to save the extracted tick.
Preserve it in a jar or small Baggie. Label it with the date, the
location of the bite, and what geographic area the tick was most

If you think you have Lyme disease
«If arash,.a flu-like illness, or joint pain develops over the next
few weeks, or even months, see your doctor — and*take along
the tick. It can be examined to determine if it carries Lyme

Diagnosing Lyme disease can be difficult. And frustrating. It
mimics the symptoms of other maladies, and in its early stages its
-presence cannot always be confirmed by blood tests. Diagnostic
blood tests are often unreliable. Scientists and doctors struggle to
establish guidelines, or criteria, for diagnosis.

And yet, early diagnosis is essential. for the treatment of the
disease. Antibiotic treatment is most effective in the early stages
of LD. Unfortunately, the longer it remains unidentifjed, or un-
treated, the less effective antibiotic treatment becomes. If left un-
treated until.the disease is well advanced, hospitalization may be
required, And symptoms can recur if the infection is not
eliminated entirely. Complete recovery can take months.

How can you protect yourself?

At present, there is no vaccine and no indication of natural
immunity after being infected. What remains a person’s best
defense is prevention. The Harrowsmith article and Ministry of.
Health bulletin offer a few guidelines:

The LD bacteria usually enter the host 12 to 24 hours follow-
ing contact. “Since the tick requires 12 to 24 hours to attach
itself and transmit the bacteria, there is ample time to remove the

a.

If you go out in the woods, here’s what you can do to protect

@ cover up (wear a hat, good shoes — not sandals — and a
long-sleeved shirt that fits snugly at the collar and cuffs)
@ wear tightly woven, light-colored clothes so that any ticks will

@ apply insect repellent containing DEET (pay special attention

@ tick repellent can also be applied to clothing, shoe tops, hat,

ods, check skin thoroughly
(baby ticks are tiny — check closely) — a thorough body search

@ check pets for ticks also (provide protection with a flea and

The closing bit of advice offered in the Harrowsmith article is
as applicable here as anywhere else in North America. ‘While the
whole story is not yet available, until scientists can give a more
thorough account of the extent of the problem, anyone going in-
to wooded areas anywhere should take the necessary precautions -
and should remain alert afterward to the symptoms of

In our area we have not yet
fulfulled the first condition. The
Lyme spirochaete itself has not
yet been found in any ticks or
humans in British Columbia. An
increasing number of individuals
are being found who meet some
or all of the other conditions.
Some of these people have re-
sponded to treatment with anti-
biotics.

Research in B.C. at the pres-

-ent has two main goals:

1. To determine if any ticks
can be found harboring the
spirochaete.

2. To learn more about the an-
tibody test and to improve it so
that it more clearly identifies the
disease.

In the meantime, there are
sensible precautions we should
all take. We can avoid exposure
to, ticks. When in the woods in
the summer months, we should:
@ wear light-colored clothes
@ wear long-sleeved shirts with
snug collars and cuffs and
closed-toed shoes
@ use repellents

@ tuck pants into socks

@ walk in the center of trails to
avoid overhanging grass and
brush

® check for ticks periodically
and remove any that are found
promptly with tweezers or
fingers

® remove clothing and wash on
return home.

If you develop symptoms sug-
gestive of Lyme disease, check
with your doctor, who can help
decide if the likelihood of Lyme
disease is sufficient to warrant
treatment.

_This is a challenging new
disease about which there are
still many unanswered ques-
tions. The results of current
research will have implications
for all of us who like to spend as
much time as possible in the
woods in the summer time.

What are your questions and

; concerns? Write us at:

“Did You Know That...”
c/o Skeena Health Unit
3412 Kalum Street
Terrace, B,C. V8G 4T2