Ticks and Lyme Disease for Healthcare Professionals
Under the Health Protection and Promotion Act all cases of Lyme disease are required to be reported to Public Health; including clinically diagnosed cases. To report a case of Lyme disease to the Grey Bruce Health Unit, please call the Infectious Disease Program at 519-376-9420 ext. 6.
The testing of ticks is a lengthy process and is not intended to guide diagnosis. Waiting for tick results could delay appropriate treatment. Health Quality Ontario has provided a clinical guidance document titled Management of Tick Bites and Investigation of Early Localized Lyme Disease to support health care practitioners with their clinical assessments. If your office suspects a case of Lyme disease, please contact the Heath Unit to report.
Human Testing - Serology
Lyme disease testing in humans can be completed through Public Health Ontario Laboratories (PHOL) who performs tests for antibodies to Borrelia burgdoferi (b. burgdoferi) using a two-tier test method as recommended by the Canadian Public Health Laboratory Network. Specimens that are positive for Borrelia species antibodies are reported to the Medical Officer of Health as per Health Protection and Promotion Act. If a positive specimen is received, the Health Unit will follow up with the testing health care practitioner for further information including: clinical signs and symptoms, history of tick bite, and travel history. Further information for Lyme disease testing and requisitions can be located on the PHO website here https://www.publichealthontario.ca/en/laboratory-services/test-information-index/lyme-disease-serology
Diagnosis of Lyme disease is primarily based on clinical symptoms and risk factors as assessed by health care practitioners. Suspect cases, clinically diagnosed cases, and laboratory confirmed cases of Lyme disease are reportable to the Health Unit. Additional information regarding Lyme disease and clinical evidence can be located on the Ministry of Health and Long-Term Care’s Infectious Disease Protocol, Appendix B – Case Definition here http://www.health.gov.on.ca/en/pro/programs/publichealth/oph_standards/infdispro.aspx#l
Health Quality Ontario’s Clinical Guidance Document Management of Tick Bites and Investigation of Early Localized Lyme Disease provides recommendations for treatment of patients with early localized Lyme disease. https://www.hqontario.ca/Portals/0/documents/evidence/qs-clinical-guidance-lyme-disease-en.pdf
The Grey Bruce Health Unit operates a tick surveillance program to monitor trends in Lyme disease vector prevalence and thereby potential risks associated with locally acquired disease. Health care practitioners and the public can submit ticks for identification and testing that are removed from humans. The Health Unit does not receive results of ticks submitted by health care practitioners. Please notify us of tick results that test positive for b. burgdoferi. Tick submission information can be located here https://www.publichealthgreybruce.on.ca/Your-Environment/Vector-borne-Diseases/Ticks
- Public Health Ontario’s Ontario Lyme Disease Estimated Risk Areas Map 2019 provides information on estimated risk areas when considering potential exposures or tick bites. This map can be located at https://www.publichealthontario.ca/-/media/documents/lyme-disease-risk-area-map-2019.pdf?la=en “Despite these estimated risk areas, it is important to note that blacklegged ticks feed on and are transported by migratory birds, meaning there is a possibility of encountering an infective blacklegged tick almost anywhere in Ontario”.
- E-Tick is an electronic tick identification platform where a picture of a tick can be submitted, and species identification results are received in approximately 48 hours. This is an identification platform only and not a tick testing program. The GBHU does not receive data information submitted to this website. This website may assist with visualizing where black legged ticks are located from information submitted by the public. Post-exposure prophylaxis for Lyme disease is recommended within 72 hours. E-Tick can be found at https://www.etick.ca/