![]() ![]() What are the clinical manifestations of LD?Ĭlinical manifestations are divided into early, localized (cutaneous) disease, and later (extracutaneous) disease.Įarly, localized (cutaneous) disease: Erythema migrans (EM) – a rash at the site of a recent tick bite – is the most common presentation in children and adults (Figures 3 and 4). The number of reported cases has increased from 128 in 2009 to an estimated ≥500 in 2013. In 2009, LD became a nationally reportable disease. Migratory birds can bring infected ticks into nonendemic areas, and people may also become infected while travelling to other endemic areas in North America and Europe. With permission from the Minister of Health, 2014īlack-legged tick populations are well established in parts of British Columbia, Manitoba, Ontario, Quebec, New Brunswick and Nova Scotia, and may be expanding. Reproduced from reference 1 © All rights reserved. ![]() Reproduced with permission from the United States Centers for Disease Control and Prevention (Atlanta, USA): Figure 2) Female black-legged ticks in various stages of feeding. įigure 1) The life cycle of black-legged ticks and Lyme disease. ![]() Removing a tick within 24 h to 36 h of its starting to feed is likely to prevent LD. Ticks can attach and feed for five days or longer ( Figure 2). If a tick is found attached to or feeding on a child, remove it as soon as possible. Immature ticks (nymphs) are responsible for most human LD infections because their very small size hinders detection. They then transfer to the host and seek an attachment site. Instead, they climb and wait on tall grasses or shrubs for a potential host to brush against them. Although there is a theoretical risk, no case of infection has been linked to blood transfusion. No relationship between treated maternal LD and abnormal pregnancies or disease in infants has been documented. Peak incidence for LD is among children five to nine years of age and older adults (55 to 59 years of age), and many cases likely go unreported. Although dogs can contract LD and carry ticks into homes and yards, there is no evidence that they spread the infection directly to people. The primary hosts (carriers) of black-legged ticks are mice and other small rodents, small mammals, birds (which are a reservoir for B burgdorferi) and white-tailed deer ( Figure 1). LD is caused by the bacteria spirochete, Borrelia burgdorferi, transmitted to humans through the bite of infected black-legged ticks: Ixodes scapularis in Eastern and Central Canada and Ixodes pacificus in British Columbia. Lyme disease (LD), a serious disease, is the most common tick-borne infection in Canada and the Northeastern to Midwestern United States, with cases also occurring (with less frequency) on the west coast. Key Words: Black-legged tick Borrelia burgdorferi Erythema migrans Post-treatment Lyme disease syndrome The present practice point reviews the epidemiology, clinical presentation, diagnosis, management and prevention of Lyme disease, with a focus on children. Geographical distribution of Ixodes ticks is expanding in Canada and an increasing number of cases of Lyme disease are being reported. The primary hosts of black-legged ticks are mice and other rodents, small mammals, birds (which are reservoirs for B burgdorferi) and white-tailed deer. The bacteria are transmitted through the bite of infected black-legged ticks of the Ixodes species. Peak incidence for Lyme disease is among children five to nine years of age and older adults (55 to 59 years of age). Lyme disease, the most common tick-borne infection in Canada and much of the United States, is caused by the bacteria Borrelia burgdorferi. Updated by: Jane McDonald, Nicole Le Saux, Infectious Diseases and Immunization Committee ![]() Heather Onyett Canadian Paediatric Society. ![]()
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