Lyme Disease and Tick Bites: What You Need to Know in Quebec
Lyme disease is a bacterial infection transmitted by tick bites. As a family physician and medical director of French origin, who completed my schooling and practiced in France before settling in Quebec, I would like to inform you about the prevention and treatment of this disease here in Quebec.
What is Lyme disease?
Lyme disease is caused by the bacterium Borrelia burgdorferi, transmitted by the bite of certain ticks. The ticks most commonly responsible for this disease in Quebec are blacklegged ticks, also known as deer ticks.
Endemic areas in Quebec
Certain regions of Quebec are more affected by the presence of ticks that can transmit Lyme disease. Endemic areas include :
-Montérégie
-Eastern Townships
-Outaouais
-Central Quebec
-Mauricie
-Montreal
-Laval
These regions are home to tick-friendly habitats such as forests, grassy areas and wetlands.
Symptoms of Lyme disease
Symptoms of Lyme disease can vary and appear in several phases:
1.early phase (days to weeks after the bite):
- Target-like redness around the bite (erythema migrans)
- Fever, chills
- Fatigue
- Muscle and joint pain
- Headaches
2Intermediate phase (weeks to months after the injection):
- Additional skin rashes
- More severe joint pain
- Heart problems (palpitations, heart block)
- Neurological disorders (facial paralysis, meningitis)
3Late phase (months to years after the bite):
- Severe arthritis
- Chronic neurological disorders
Diagnosis of Lyme disease
The diagnosis of Lyme disease is based on several factors:
-Tick bite history: Tell your doctor about any recent tick bite or visit to a high-risk area.
-Clinical symptoms: Clinical signs such as erythema migrans are key indicators.
-Blood tests: Serological tests can detect antibodies against the Borrelia burgdorferi bacterium. However, these tests may be negative in the first few weeks of infection.
Tick bite prevention
Prevention is essential to reduce the risk of contracting Lyme disease. Here are a few steps you can take:
-Protective clothing: Wear long clothing, socks and closed shoes when walking in forests or grassy areas.
-Repellents: Use repellents containing DEET or permethrin on skin and clothing.
-Body inspection: After every outing, thoroughly inspect your body and that of your pets for ticks.
How long should a tick stay attached?
To increase the risk of transmitting the bacteria responsible for Lyme disease, the tick must generally remain attached to the skin for at least 24 to 36 hours. The sooner the tick is removed, the lower the risk of contracting the disease.
What to do in the event of a tick bite?
If you find a tick attached to your skin, follow these steps:
1.tick removal:
- Use fine forceps to grip the tick as close to the skin as possible.
- Pull gently but firmly to remove the tick without crushing it.
- Clean the bite area with rubbing alcohol or soap and water.
2.symptom monitoring:
- Note the date of the injection.
- Watch for symptoms over the following weeks.
3.medical consultation:
- Consult a doctor if you develop symptoms of Lyme disease.
- A follow-up consultation may be requested by the doctor to ensure that there are no complications.
Post-exposure prophylaxis
Since 2017, post-exposure prophylaxis (PEP) with a dose of doxycycline can be offered following a tick bite in Quebec, under certain conditions. Every year, the Institut national de santé publique du Québec (INSPQ) identifies the areas concerned using acarological or human surveillance data.
Considering that the data on which the presumed efficacy of PEP is based are considered to be of low scientific proof, and that the results are not necessarily generalizable to the Quebec context, the INESSS recommends that the offer of PEP be made as part of a shared decision process between the patient and the healthcare professional. When the tick bite has occurred in a geographical area identified by the INSPQ, the offer of PEP may be considered when the following conditions are met:
- Possibility of identifying a tick (tick left attached to the skin or removed and collected in a container, photographed or well described)
- Absence of symptoms suggestive of Lyme disease
- Delay of 72 hours or less between the removal of the tick and the presumed time of taking the PEP
- Tick attaches to skin for 24 hours or more
If these criteria are met, a single dose of doxycycline (200 mg for adults, 4 mg/kg for children over 8, with a maximum dose of 200 mg) can be administered.
Treatment of Lyme disease
Early treatment of Lyme disease usually involves antibiotics for a few weeks. Common options include:
-Doxycycline: often prescribed for adults and children over 8.
-Amoxicillin: an alternative for pregnant and breastfeeding women and young children.
-Cefuroxime axetil: another option for those who can't take doxycycline or amoxicillin.
The earlier treatment is started, the better the chances of a complete cure. More advanced cases may require longer treatment and additional care to manage complications.
Conclusion
Lyme disease is a serious but preventable and treatable infection, if treated promptly. By being vigilant and taking preventive measures, you can significantly reduce your risk of contracting this disease. Don't hesitate to consult a healthcare professional if you have any concerns or questions about tick bites and Lyme disease.
For any medical consultation or question, you can contact us and book an appointment on our AlloDocteur.ca website. We offer home visits in Montreal starting at $279, depending on the complexity and location of the consultation.
