News & Views

Why do Canadians record so few cases of Lyme disease as compared to Americans?

W. Gifford-Jones MD & Diana Gifford-Jones

May 1, 2023

BY W. GIFFORD- JONES MD & DIANA GIFFORD-JONES

It’s tick season and the little pests are out with a vengeance. Tiny as they are, ticks are a huge nuisance and a hazardous vector of disease. Their ability to latch onto unsuspecting hosts has made them one of the most successful blood-sucking parasites on the planet.

Ticks are the primary carriers of Lyme disease, infecting people with their bite. Do ticks, or people account for the sizable difference in the number of reported cases in the US and Canada? Every year, in the United States, about half a million people are diagnosed with Lyme disease. Based on population, all other things equal, one would expect about 50,000 cases annually in Canada. Other things, however, must not be equal. According to the Public Health Agency of Canada, only 3,147 cases were reported in Canada in 2021, up from 144 in 2009.

Is geography behind this huge difference? Ticks that transmit Lyme are found in most parts of the US and have expanded into the areas of Canada where most people live over the past two decades.

Challenges with diagnosis of Lyme disease might help explain the gap. When diagnosed early, a course of antibiotics is an effective treatment. If untreated, the bacteria causing infection can linger in the body for months or years before presenting symptoms ranging, for example, from short-term fevers, rashes, and fatigue to more devastating conditions.

An attack on the central nervous system could be one manifestation. This can cause numbness, pain, stiff neck, headache, and many other symptoms, including psychiatric problems.

Another concern is the cardiovascular system, where Lyme disease can disrupt electrical signals that coordinate heart beats.

Painful swelling of joints is a common feature.

Celebrities have shared their experience with long lists of problems. Among them are musicians: Aril Lavigne, Shania Twain, and Darryl Hall, actors Alec Baldwin and Ben Stiller, writer Amy Tan, and even President George W. Bush.

How can these stars, and even a president, fall victim? Ticks are stealthy. They can bite people and feed for a day, or more before dropping off undetected.

Tick saliva is amazing stuff, containing: antimicrobials, analgesics, blood thinners, and immune suppressors in cocktails that change according to the situation. It’s this saliva that enables ticks to bite and feast without notice. What’s more, unlike female ticks, which become engorged, male ticks don’t eat such a big meal, making them very hard to notice.

Ticks can’t jump to catch a ride. They “quest” by perching on the tips of grasses, leaves, and branches, then use their forward legs to grab hold when a host brushes up. So stay out of long grasses in areas home to deer, rabbits and field mice. Be wary of other places where ticks might catch a human host. For instance, ticks are commonly found in grasses, bushes and treed areas of golf courses. Any pet dog stepping into long grass or jumping in and out of ditches could pick up ticks, and then bring them in the home where close contact with owners can easily occur.

Why do Canadians record so few cases of Lyme disease as compared to Americans? Lack of awareness of the disease among healthcare providers and low sensitivity of diagnostic tests are part of the answer. Additionally, one study found that Canadians tend to seek medical care less frequently for tick bites and are less likely to be tested for Lyme disease, leading to a 40% lower detection rate.

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Written By W. Gifford-Jones MD & Diana Gifford-Jones

Dr. W. Gifford-Jones, MD is a graduate of the University of Toronto and the Harvard Medical School. He trained in general surgery at Strong Memorial Hospital, University of Rochester, Montreal General Hospital, McGill University and in Gynecology at Harvard. His storied medical career began as a general practitioner, ship’s surgeon, and hotel doctor. For more than 40 years, he specialized in gynecology, devoting his practice to the formative issues of women’s health. In 1975, he launched his weekly medical column that has been published by national and local Canadian and U.S. newspapers. Today, the readership remains over seven million. His advice contains a solid dose of common sense and he never sits on the fence with controversial issues. He is the author of nine books including, “The Healthy Barmaid”, his autobiography “You’re Going To Do What?”, “What I Learned as a Medical Journalist”, and “90+ How I Got There!” Many years ago, he was successful in a fight to legalize heroin to help ease the pain of terminal cancer patients. His foundation at that time donated $500,000 to establish the Gifford-Jones Professorship in Pain Control and Palliative Care at the University of Toronto Medical School. At 93 years of age he rappelled from the top of Toronto’s City Hall (30 stories) to raise funds for children with a life-threatening disease through the Make-a-Wish Foundation. Diana Gifford-Jones, the daughter of W. Gifford-Jones, MD, Diana has extensive global experience in health and healthcare policy. Diana is Special Advisor with The Aga Khan University, which operates 2 quaternary care hospitals and numerous secondary hospitals, medical centres, pharmacies, and laboratories in South Asia and Africa. She worked for ten years in the Human Development sectors at the World Bank, including health policy and economics, nutrition, and population health. For over a decade at The Conference Board of Canada, she managed four health-related executive networks, including the Roundtable on Socio-Economic Determinants of Health, the Centre for Chronic Disease Prevention and Management, the Canadian Centre for Environmental Health, and the Centre for Health System Design and Management. Her master’s degree in public policy at Harvard University’s Kennedy School of Government included coursework at Harvard Medical School. She is also a graduate of Wellesley College. She has extensive experience with Canadian universities, including at Carleton University, where she was the Executive Director of the Global Academy. She lived and worked in Japan for four years and speaks Japanese fluently. Diana has the designation as a certified Chartered Director from The Directors College, a joint venture of The Conference Board of Canada and McMaster University. She has recently published a book on the natural health philosophy of W. Gifford-Jones, called No Nonsense Health – Naturally!

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