Lyme disease is caused by a bacteria carried and spread by ticks. One tick bite allows the bacteria to enter the body, entrenching themselves within tissues and then migrate throughout the body. The Lyme bacteria has the ability to evade the body’s immune system and causes innumerable symptoms making it very difficult for many physicians to diagnose.
Due to the multi-system symptoms, Lyme disease is often misdiagnosed as lupus, multiple sclerosis, rheumatoid arthritis, fibromyalgia, irritable bowel syndrome, Crohn’s disease or chronic fatigue. Due to its’ affect on the nervous system, Lyme disease in children can result in learning disabilities, poor attention span, memory and word finding difficulty, often interfering with the child’s academic ability.
Lyme disease is the most prevalent bug-borne illness. It is estimated that there are now 3 million cases in the United States with the Centre for Disease control reporting approximately 20,000 new cases yearly – but this is thought to be underestimated 10 fold. Most of these cases have been identified in states bordering Canada, however Canada reports only a few hundred cases a year and does not recognize several of its’ provinces as even having the disease.
With the approach of spring in the northern hemisphere, people will be out more enjoying the warm weather and health care personnel should be increasing alert to the possibility of Lyme disease in our population. Health promotion and disease prevention being our first priority. It is important for people to understand that you need not be in the “woods” to be exposed to ticks.
Ticks are transported to lawns, gardens, low bushes, wild grasses, weeds, and especially along pathways by mice, birds or deer. Pets can also transport the ticks into our homes. Wear pants tucked into socks, light coloured clothing and long sleeves, preferably using DEET repellent. It is important to perform “tick checks” regularly over the entire body, especially warm moist areas.
Secondly, Lyme disease treatment is most effective with early diagnosis. It is therefore important for Canadian front line nurses to collect concise and accurate information from their clients. Since many of the early symptoms are flu-like, such as fever, headache, fatigue, nausea, muscle ache, jaw pain, red eyes, and stiff neck, it is easy to see how clinical diagnosis is difficult.
he Canadian Lyme Disease Foundation has prepared a checklist of 75 symptoms of Lyme disease and clients are asked to indicate which symptoms they are or have experienced. It is suggested that 20 YES responses represent a serious potential and Lyme disease should be included in the diagnostic workup. This would be an excellent tool to assist nurses with their data collection. The checklist can be found at: http://www.canlyme.com/patsymptoms.html
Thirdly, it is important to collect any tick specimens that are removed from clients and submit them for accurate identification along with the region in which it was obtained. According to the Canadian Lyme Disease Foundation, Canadian medicine, due to the lack of recognition of the clinical diagnosis, combined with lack of surveillance and research, places Canada low on the scale in dealing with this crisis.
Reporting is therefore a vital step to ensure that Lyme disease is not ignored by Public Health and this will hopefully reflect in better diagnostics, public education programs, and improved training for medical personnel in recognition and treatment.
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