Background

Lyme disease is a bacterial disease with no known cure that can be most effectively treated when caught in its early stages. Since 2016, the cases have been steadily increasing as seen in the figures below.

Figure 1 - Lyme disease cases recorded in Canada as a function of year.

The number of cases recorded is per 100,000 people in the Canadian population. The data provided is courtesy of the Government of Canada Lyme Surveillance Project.

Year	Number of Cases in Canada
2016	992
2017	2025
2018	1487
2019	2636

Table 1 - The number of Lyme Disease cases recorded in Canada from 2016 until 2019 .

In Canada, Lyme disease infection rates are greatest in our province of Ontario and are continuing to grow rapidly (1). This highlights Ontario's higher risk of Lyme disease compared to other provinces as it is the largest contributor to these growing numbers in Canada. Beyond this, it is assumed that up to 10% of Lyme disease cases go unreported, suggesting that the problem is greater than reported (2).

Figure 2 - Canadian Lyme Disease Case Rates in 2016.

The figure above shows the rates of Lyme disease in Canada in the year 2016 divided up by rates per province as well as by confirmed cases and probable cases. The standard for a case being confirmed is for a patient to test positive for 5 of the 10 marker proteins present in borrelia burgdorferi in a western blot test. All data provided is from the Public Health Agency of Canada (PHAC) and all credit goes to them (1).

Project

Many tests currently exist for diagnosing Lyme disease. The gold standard tests include the ELISA test and the Western blot test. The ELISA test consists of a detection of an immune response to the Borrelia bacteria. Similarly, the Western blot test is a detection of proteins specific to Borrelia burgdorferi. While these methods are very reliable, the tests must be performed in specialized laboratories that are not found in many cities. As an example, samples taken in Kingston, our hometown, must be shipped to the nearest big city of Toronto for testing which takes about 5 days.

Figure 3 - ELISA test.

These tests currently differ between humans and other Lyme disease-carrying animals, however, the need for a fast, universal diagnosis is undeniable. By solely focusing on the pest and not the host, these tests will rely on fewer variables. As a result, the team hopes to design more specific and sensitive tests that will decrease the rate of false positives and false negatives. By using a biosensor, the tests will be cheap, fast, and easy to use. Additionally, this will eliminate the need to ship samples and wait for their results.

Growing Problem

There are many theories why Lyme disease case numbers are increasing rapidly. One prominent theory is that the vectors responsible for transferring the infection, ticks (Ixodes scapularis), are expanding their range as temperatures increase in more northern regions that were once unviable (3).

This problem may be particularly prevalent in our local region, but it is not exclusive to Ontario. About 85,000 cases of Lyme disease are reported annually in Europe and between 15,000 - 20,000 cases are reported annually in the United States, with the disease being endemic in 15 states (4). Lyme disease has also surfaced and begun to spread in Asian countries like China, Korea, Japan, Indonesia, Nepal, and eastern Turkey (5, 6).

Impact

Human Symptoms

If Borrelia Burgdorferi is caught in its early stages, patients can undergo treatment with antibiotics. A wide range of symptoms can occur depending on the stage of infection. In the first 3-30 days, patients will likely see the formation of erythema migrans (the “bulls-eye” rash) as well as fever, chills, headache, fatigue, muscle and joint pain, and swollen lymph nodes. As the infection persists past the first month, patients will likely experience severe headaches and neck stiffness, facial palsy, high occurrence of rashes, arthritis and severe joint pain, pain in the tendons and muscles, heart palpitations, episodes of dizziness, shortness of breath, inflammation of the brain and spinal cord, and shooting pains or numbness in the hands and feet (7).

Other Impacts

Often, humans are very attentive to themselves and will quickly notice if a tick has bitten them. If the tick goes unnoticed, the erythema migrans can alert people that they are infected and should seek treatment immediately.

However, animals, such as dogs, rabbits, cows, and horses frequently run through tall grass and wooded areas where ticks are typically found. As a result, these animals pick up ticks far more frequently than humans do. Since these animals typically have fur, the ticks can hide, making it harder to notice their presence. Once bitten, animals do not develop an erythema migrans (“bulls-eye” rash), further hiding the infection (8).

The symptoms will differ between species, but the diagnosis will typically occur in a very late stage of the infection when animals will act as if they are “walking on eggshells”. These animals will develop high fevers, swollen joints, exhibit painful lameness and begin limping, and may stop eating. The earliest a veterinarian can test animals for the presence of the generated antibodies in response to Borrelia Burgdorferi (the standard method of diagnosis) is 4 weeks, but most animals will not be diagnosed for about a year (8, 9).

By testing the tick itself, the team can create a diagnostic test for the presence of Borrelia Burgdorferi, appicable to both humans and animals.

References

1. Public Health Agency of Canada (2021) Surveillance of Lyme disease - Canada.ca. [online] https://www.canada.ca/en/public-health/services/diseases/lyme-disease/surveillance-lyme-disease.html (Accessed June 3, 2021)

2. Ogden, N. H., Bouchard, C., Badcock, J., Drebot, M. A., Elias, S. P., Hatchette, T. F., Koffi, J. K., Leighton, P. A., Lindsay, L. R., Lubelczyk, C. B., Peregrine, A. S., Smith, R. P., and Webster, D. (2019) What is the real number of Lyme disease cases in Canada? BMC Public Health. 19, 1–12

3. Sonenshine, D. E. (2018) Range expansion of tick disease vectors in north america: Implications for spread of tick-borne disease. Int. J. Environ. Res. Public Health. 10.3390/ijerph15030478

4. Lindgren, E., and Jaenson, T. G. T. (2006) Lyme borreliosis in Europe: influences of climate and climate change, epidemiology, ecology and adaptation measures

5. Stone, B. L., Tourand, Y., and Brissette, C. A. Brave New Worlds: The Expanding Universe of Lyme Disease. 10.1089/vbz.2017.2127

6. Masuzawa, T. (2004) Terrestrial Distribution of the Lyme Borreliosis Agent Borrelia burgdorferi Sensu Lato in East Asia

7. Shor, S., Green, C., Szantyr, B., Phillips, S., Liegner, K., Burrascano, B., Bransfield, R., and Maloney, E. L. (2019) Chronic lyme disease: An evidence‐based definition by the ILADS working group. Antibiotics. 10.3390/antibiotics8040269

8. Littman, M. P., Gerber, B., Goldstein, R. E., Labato, M. A., Lappin, M. R., and Moore, G. E. (2018) ACVIM consensus update on Lyme borreliosis in dogs and cats. J. Vet. Intern. Med. 32, 887–903

9. Richter, D., and Matuschka, F. R. (2006) Modulatory effect of cattle on risk for lyme disease. Emerg. Infect. Dis. 12, 1919–1923

Background Project Growing Problem Impact References Go to Top

Team:Queens Canada/Background