Surveillance for Lyme disease in Canada: 2009–2015

Gasmi, Salima; Ogden, Nicholas H.; Lindsay, L. Robbin; Burns, S; Fleming, Sarah; Badcock, J; Hanan, S; Gaulin, Colette; Leblanc, Marie-Andree; Russell, Curtis; Nelder, Mark P.; Hobbs, L; Graham-Derham, S; Lachance, Lisa; Scott, Allison N.; Galanis, Eleni; Koffi, Jules K.

doi:10.14745/ccdr.v43i10a01

Cited by 81 publications

(103 citation statements)

References 6 publications

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“…Lyme disease is caused by B. burgdorferi, which can infect I. scapularis ticks in central and eastern Canada and I. pacificus ticks in British Columbia. It has been reported in every province from British Columbia to Prince Edward Island (PEI) and it is well-known that LD is on the rise (13). Lyme disease typically presents with an erythema migrans rash and non-specific symptoms such as fatigue, fever, headache and muscle and joint pains and, if left untreated, can become a multisystem disease.…”

Section: Lyme Diseasementioning

confidence: 99%

“…It is now widely acknowledged that the increase in temperature associated with climate change has contributed to a general increase in the number, types, level of activity and geographical distribution of ticks in North America (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11) and has directly contributed to the northward spread of blacklegged ticks and LD into Canada (12). As a result, LD has emerged in Canada and the number of reported cases of Lyme disease continues to rise (13,14).…”

Section: Introductionmentioning

confidence: 99%

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Increased risk of tick-borne diseases with climate and environmental changes

Bouchard

Dibernardo

Koffi

et al. 2019

CCDR

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199

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Climate warming and other environmental changes have contributed to the expansion of the range of several tick species into higher latitudes in North America. As temperatures increase in Canada, the environment becomes more suitable for ticks and the season suitable for tick activity lengthens, so tick-borne diseases are likely to become more common in Canada. In addition to Lyme disease, four other tick-borne diseases (TBDs) have started to emerge and are likely to increase: Anaplasmosis; Babesiosis; Powassan virus; and Borrelia miyamotoi disease. Increased temperature increases the survival and activity period of ticks, increases the range of both reservoir and tick hosts (e.g. mice and deer) and increases the duration of the season when people may be exposed to ticks. Other ticks and TBDs may spread into Canada as the climate changes. The public health strategies to mitigate the impact of all TBDs include surveillance to detect current and emerging TBDs, and public health actions to prevent infections by modifying environmental and social-behavioral risk factors through increasing public awareness. Clinical care strategies include patient education, early detection, laboratory testing, and treatment. Affiliations

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Section: Lyme Diseasementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Increased risk of tick-borne diseases with climate and environmental changes

Bouchard

Dibernardo

Koffi

et al. 2019

CCDR

Self Cite

199

134

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“…In Canada, the first blacklegged ticks were reported in the 1970s, followed by a range expansion in the mid‐1990s along the northern shore of Lake Erie, Lake Ontario, and the St. Lawrence River which triggered public health action in 2005 to implement provincial surveillance on the emerging vector‐borne disease in Ontario. The incidence of LD has continued to rise over the last decade, and climate projections estimate future range expansion of the blacklegged tick will continue over the next decade to further increase the risk of LD in Canada (Gasmi et al, ; McPherson et al, ).…”

Section: Introductionmentioning

confidence: 99%

Estimating direct healthcare costs attributable to laboratory‐confirmed Lyme disease in Ontario, Canada: A population‐based matched cohort study using health administrative data

Shing

Wang

Khoo

et al. 2019

Zoonoses and Public Health

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The objective of this study was to determine healthcare costs attributable to laboratory-confirmed Lyme disease (LD) from the healthcare payer perspective in Ontario, Canada. A cost-of-illness study was conducted for incident LD subjects from 1 January 2006 through 31 December 2013 ascertained from provincial laboratory and reportable disease databases, linked to health administrative data. All LD subjects included were laboratory-confirmed, according to provincial case definitions.Incident LD subjects were propensity-score matched to uninfected subjects on age, sex, comorbidities and urban/rural status. We used phase-of-care methods to calculate attributable costs for two phases of illness: initial care (≤30 days following "index date") and continuing care (>30 days after index date to the end of the follow-up period). A total of 663 incident, confirmed LD subjects were identified from 2006 through 2013. Mean age was 44.2 ± 20.1 years; 339 (51.1%) were female; and 31 (4.7%) were hospitalized ≤30 days after index date. Six hundred fifty-eight (99.2%) LD subjects were matched to uninfected subjects; mean follow-up time was 3.3 years.Mean attributable costs per case during the initial care phase and continuing care were $277 (95% CI: $197, $357) and −$5 (−$27, $17), respectively. Attributable costs per LD subject aged 5-14 years were $440 ($132, $747), greater than the costs observed for other age strata. Expected 1-year attributable costs were $832, given continuing care costs were negligible. Limitations to our study include estimating costs using a cohort of only laboratory-confirmed LD cases, introducing selection bias for diagnosed and treated patients who may have a lower risk of developing sequelae. In conclusion, the initial care phase of LD is associated with increased healthcare costs, but without significant costs attributable to LD infection after 30 days.Estimates of costs attributable to LD are important for healthcare resource prioritization and the evaluation of novel interventions. K E Y W O R D Scost analysis, healthcare resource use, Lyme disease

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“…Lyme disease case counts in Canada increased by a factor of six from 2009 through 2015, with the majority of cases reported in Ontario (10). This has been associated with an expansion in the geographic range of blacklegged ticks in Canada, including northern regions of Ontario.…”

Section: Introductionmentioning

confidence: 99%

The continued rise of Lyme disease in Ontario, Canada: 2017

Nelder

Wijayasri

Russell

et al. 2018

CCDR

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Background: Lyme disease is an infection caused by the spirochete Borrelia burgdorferi and, in most of North America, is transmitted by the blacklegged tick Ixodes scapularis. Climate change has contributed to the expansion of the geographic range of blacklegged ticks in Ontario, increasing the risk of Lyme disease for Ontarians. Objective: To identify the number of cases and incidence rates, as well as the geographic, seasonal and demographic distribution of Lyme disease cases reported in Ontario in 2017, with comparisons to historical trends. Methods: Data for confirmed and probable Lyme disease cases with episode dates from January 1, 2012, through December 31, 2017, were extracted from the integrated Public Health Information System (iPHIS). Data included public health unit (PHU) of residence, episode date, age and sex. Population data from Statistics Canada were used to calculate provincial and PHU-specific incidence rates per 100,000 population. The number of cases reported in 2017 by PHU of residence, month of occurrence, age and sex was compared to the 5-year averages for the period 2012-2016. Results: There were 959 probable and confirmed cases of Lyme disease reported in Ontario in 2017. This was three times higher than the 5-year (2012-2016) average of 313. The provincial incidence rate for 2017 was 6.7 cases per 100,000 population, although this varied markedly by PHU. The highest incidence rates were found in Leeds-Grenville and Lanark District (128.8 cases per 100,000), Kingston-Frontenac, Lennox and Addington (87.2 cases per 100,000), Hastings and Prince Edward Counties (28.6 cases per 100,000), Ottawa (18.1 cases per 100,000) and Eastern Ontario (13.5 cases per 100,000). Cases occurred mostly from June through September, were most common among males, and those aged 5-14 and 50-69 years. Conclusion: In 2017, Lyme disease incidence showed a marked increase in Ontario, especially in the eastern part of the province. If current weather and climate trends continue, blacklegged ticks carrying tick-borne pathogens, such as those causing Lyme disease, will continue to spread into suitable habitat. Monitoring the extent of this geographic spread will inform future clinical and public health actions to detect and mitigate the impact of Lyme disease in Ontario.

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Surveillance for Lyme disease in Canada: 2009–2015

Cited by 81 publications

References 6 publications

Increased risk of tick-borne diseases with climate and environmental changes

Increased risk of tick-borne diseases with climate and environmental changes

Estimating direct healthcare costs attributable to laboratory‐confirmed Lyme disease in Ontario, Canada: A population‐based matched cohort study using health administrative data

The continued rise of Lyme disease in Ontario, Canada: 2017

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