The Current - How to protect yourself against tick-borne illnesses

Episode Date: June 25, 2025

As the climate warms, ticks are finding more places to call home within Canada — and spreading more diseases to people wherever they go. A doctor talks about why Lyme disease isn’t the only infection you can catch from ticks, and how to protect yourself against the bugs.

Ten years ago, I asked my partner Kelsey if she would marry me. I did that, despite the fact that every living member of my family who had ever been married had also gotten divorced. Forever is a Long Time is a five-part series in which I talk to those relatives about why they got divorced and why they got married. You can listen to it now on CBC's Personally. This is a CBC Podcast. Hello, I'm Matt Galloway and this is the current podcast. When I was growing up in Saskatchewan, there were lots of summer insects to worry about. Mosquitoes, black flies, bloodsuckers. Ticks? Not so much. Not at all, actually. That was then.

Now ticks are everywhere and the diseases they carry, including Lyme, are a growing concern. Twenty years ago, it was rare for Dr. Mirabelle Kelly to see a patient with Lyme disease. Today, Dr. Kelly lives and practices in Granby, Quebec and Lyme disease and other tick-borne illnesses are common. Dr. Mirabelle Kelly is a medical microbiologist and infectious disease specialist at the Granby Hospital and Brome-Missouquois hospitals in Quebec. She also helped develop a treatment and diagnostic plan for Lyme disease for Quebec's National Institute for Excellence in Health and Social Services. Dr. Kelly, good morning. Good morning.

You know, not so long ago, people in Canada who thought they might have Lyme disease were told that there wasn't any in Canada. What changed? So we think there are many factors that have influenced the development and growth of the population of ticks in our area. The main one is climate change. So the warming of the weather of the climate has enabled the ticks to survive our cold winters. So that's the main thing. Experts from the national lab tell us that the progression is estimated to be about 50 kilometers north every year. So the population of ticks gains some territory and while it does so, humans become more exposed to them. So climate change is the main factor. But there are other

factors. You know, humans are growing, the human population is growing, they're going into areas, The human population is growing, they're going into areas, residential developments have been going into areas where ticks are living, so there's been more contacts. And also, I would say this equilibrium of the different species, so more deer that are present, and the deer is involved in the reproductive cycle of the ticks. So it's all kinds of factors that influence the growth population in our area. What other infections can ticks cause besides Lyme disease? Yeah, so when we're talking about ticks in general, there are many different kinds of ticks in Canada. But the main one that we're concerned about

is the black-legged tick, Ixodais scapularis or Ixodais pacificus, which is a little cousin of scapularis but out west. And we know of six diseases that this tick carries. So by far the most frequent is Borrelia burgdorferi, which causes Lyme's disease, but there are five other pathogens that can be carried by this tick. Now, the one we've been seeing most apart from Lyme's disease is Anaplasma, Anaplasma phagocytophilum.

So this is also a bacteria that's carried into, that infects white blood cells. So it causes mainly fevers and chills, pain in the muscles and joints. and it can be quite severe. So younger patients usually tolerate it relatively well. Our elderly population being infected are pretty sick, and we've had many patients hospitalized with this infection. Then we have babesia.

We've been starting to see a few cases of babesia in my area. So babesia is a parasite. It's not a bacteria like the two others, a parasite that looks a lot like malaria. It's a parasite that goes into the blood and infects red blood cells. So this is another concern. We've seen about five cases in the last year, so it's a very new infection to this area. And then there's also Powassan encephalitis, which is a virus. This virus has been seen once in my area last year, so it's pretty rare. So you've mentioned the symptoms and sometimes serious consequences, but what concerns you most about the increase in infected ticks? What is that

telling you? Well, for me, you know, I've been seeing these, these infections going on the rise for the last years. I've been presenting in different, you know, conferences about ticks and Lyme's disease and I had to read a lot to understand what were the reasons behind this increase. So it got me interested in climate change. And I think for me, it has transformed me because the ticks have been, you know, sending a message. It's warming up and we have to do something about it. We have to be concerned about it and change our ways. So for me, the tick infections, you

know, Lyme's disease is one thing, but they're showing us that our climate is warming. There are also other effects on health health obviously, but I realize that I'm a witness, a privileged witness of this climate change and the effects it has on our health. I really feel I need to speak about this and make people realize that this is only a sign of something bigger. And that's just from ticks, obviously. Are you of the opinion that climate change will also reveal other changes in our natural population that can be harmful to us? It'll change many things. For example, you know, my family is a maple sugar producer. We're maple sugar producers and we're kind of worried to see how climate change will affect the population of trees in our area. Saps season will be also changed.

We're talking about water change. But in my area, in my expertise, I'm concerned with health changes, health impact. So of course, tick-borne diseases, mosquito-borne diseases are on the rise due to climate change. And Dr. Kelly, you spoke about some of the severe consequences of some of these diseases borne by ticks. When are we most at risk of getting bitten by ticks? A little bit of practical advice for our listeners. Yes.

So the nymph phase is the most at risk. So that's the phase that starts when the nymphs emerge from the snow in early spring. So in my area, it's mid-March, we're starting to see nymph bites and nymphs being brought to our lab for identification. That would be the start of the season. Why are they most important? Because they're so small, so they can be easily missed. And then the nymph phase of the tick life cycle continues until early

summer. You have an image of people wanting to enjoy the outdoors, summer, like came late this year for example. Is this the time we should be cautious of? Well, what I see practically is really, well, mid-March to early July. So that's the nymph phase that we see most. And then for some reason, July and August are more quiet, probably because that's the larvae stage of the cycle. And the larvae tend to bite mostly small animals, so white-footed mouse, small birds.

And so the humans are less bitten by the larvae. But obviously, as the season goes on, those that were bitten in the early spring and beginning of June, they start having the symptoms. So we as clinicians see the patients coming in throughout the year. But for the biting season, it's mostly spring and early summer. And what are some practical things to share about how people can avoid getting bitten by ticks in either

of those early or summer seasons? So the first thing is to be wary about their size, they're so small that you really have to be careful and inspect yourself after each time you go into a wooded area or are at risk of being exposed. So I think the tick check is the main thing. Of course, you can try to protect yourself more either by putting, we say, light colored clothing because they're easier to see on a white background.

Try to tuck your clothing so that the ticks have a harder time reaching your skin. But also, there are two main products that are approved by Health Canada for tick repellents. So DEET products have most efficacy. And then echaridine is recommended for children. So for families, echaridine would be the best product. Both are long-acting and really a good repellence against ticks. Is drinking raw milk safe like RFK Junior suggests? Can you reduce a glucose spike if you eat your food in quote unquote the right order? I'm registered dietitian, Abbey Sharp.

I host a nutrition myth busting podcast called Bite Back with Abbey Sharp. And those are just some of the questions I tackle with qualified experts on my show. On Bite Back, my goal is to help listeners create a pleasurable relationship with food, their body, and themselves, which in my opinion is the fundamental secret to good health. Listen to Bite Back wherever you get your podcasts. I want to talk about Lyme disease. As the cases rise, what are you learning about the treatment of this disease? I would say our protocols are working very well in the moment, but I would say in my recent experience it's mostly learning how to treat and recognize other infections caused by ticks, so other than Lyme's disease, because Lyme's disease we've had experience for the last 10 years

at least with this disease and we're getting pretty used to treatments. There are zones of uncertainty, like for example about 5 to 10% of patients with Lyme's disease are having persistent symptoms of fatigue. But we see that percentage with pretty much all infections, you know, you come in with a pneumonia or meningitis, you will be tired for a while. So I wouldn't say it's that different from other general infections, but we are seeing those patients that are feeling tired after treatment and we don't think it's a persistent infection, but it's just infection-related fatigue after treatment and that's a bit hard to manage. Is there a vaccine for Lyme disease or should there be? Well there was there has been a vaccine developed in the 1980s, early 90s. It was called Limericks. It was developed in the United States

and also distributed but many people complained of symptoms of side effects of the vaccine. So there was a class action. People tried to remove the vaccine from use, and the company, due to this bad publicity, and also the population was not asking for it anymore, they just stopped producing it. But now there's been renewed interest in the vaccine, and it has been produced by a European company called Valneva, and Pfizer has taken over to do some more studies. I know it's being studied at different sites in Canada right now and we're awaiting results for the next in the next two years. So it's mainly a study about the vaccine safety and efficacy that's going on so we're waiting for those results before we can have it distributed in Canada. So I'm curious, given the rise of cases, but still compared to other diseases, perhaps fewer cases and less

severe consequences. And there is, you know, some resistance against vaccines, more vaccines. Do you think this is the way we should treat these diseases? Dr. Mollie-Morris Well, vaccines are one of the preventive measures to avoid Lyme's disease, but they don't protect from the other diseases. So I would say the vaccine is one tool amongst others, but of course tick checks are more important because it also avoids being exposed to other diseases caused by ticks, and there might be emerging diseases that we don't know about yet. Yes, I think it's a good step. It's a good tool to have in our toolbox vaccines, but they're not the panacea.

They're not all-encompassing. They don't prevent other diseases caused by ticks, so we still have to be careful and use the basic preventative measures I spoke about earlier. And just again turning back to the pragmatic part of this discussion, what should people look out for after they've been outdoors? If you're going to give us some last advice here, how do we find ticks and what do we do with them if we find them? Well, depending on which area in Canada you live,

because it might depend on local protocols. In my area, for example, when a person finds a tick, we participate in the hospitals in the tick surveillance programs. So about 100 ticks per year are sent to the provincial lab and then sent eventually to the national lab where there's statistical analyses of the different ticks to know in which area which pathogens are found, but it doesn't help the patients really because it's really a surveillance program. But other than that, you don't need to bring the tick to be tested because we don't test the ticks for the patients.

The reason why we don't do that is because first of all, the tick might be a carrier but might not have transmitted the disease. So it doesn't mean because you have a tick carrying, for example, Lyme's disease, that the tick has transmitted it to the patient. And even if the tick is negative, it doesn't mean that there hasn't been another tick biting the patient that has gone unnoticed. And then, you know, it would give a false security to say that the tick wasn't a carrier, the patient was exposed to ticks so might be eventually sick with some disease. So we don't

use the tick surveillance for you know the clinical use, we don't use it to guide the treatment of the patient. It's mostly for surveillance to know what's going on in our areas and adjust our clinical evaluation according to which pathogens are in our area. So Dr. Kelly, just lastly, you know, some of our listeners may not even know what a tick looks like, having never seen one and hard to find. So what should we look for? So when you examine yourself, ticks are like little grains of sand. They're very hard and they're very small, especially the nymphs, as I said, when they're found in the spring, they're about a few millimeters, 1.5 millimeters in size. So they can be easily missed. They like to

hang out in warm and humid areas, so on the body that would correspond to skin folds, you know, the axillary area, the armpits, any folds, buttocks, behind the legs, that's mostly where you can find them. And when you pass your hand over your skin, you would feel kind of a little grain of salt. People often think, you know, it was just like a little grain of dust oftentimes when they don't know what it is. But it's so hard and you can feel it's not like a part of the skin. It's just harder than the regular skin. So it can be, you know, easily missed. But when you examine, you put your hand over your skin, you feel that there's something like a grain of, I would say like

dust or earth that you could feel very hard. And then when you look closely, you can see the head of the tick into the skin. Then you know it's a tick as it moves. So it's important if you can have a tool to remove the ticks. There are different tools. You can use tweezers, but I find the little hooks, plastic hooks that they sell in the pharmacies, are the most useful, they're the most easy to use.

Sounds like quite a forensic you need to do after you go out in the outdoors to find ticks. Yes, and there are places of the body that are hard to see. So it's, of course, if you have a partner that can help you, for example, in the back, you know, half of the body that are hard to see. So it's of course if you have a partner that can help you, for example in the back, you know half of the people who develop Lyme disease never saw a tick because they're so hard to see. If you see them you remove it immediately and the risk is really almost zero if you remove them in the first 24 hours. So obviously if you see a tick on your hand it will be easy to notice and you'll remove it more quickly. But people who develop the later stages of disease

often never, you know, 50 percent of the time never saw the tick or the erythema, the first phase of the disease, the erythema migrans. So often we see those patients coming in with lesions. When we do see them clinically, they're often in areas that are hard to find. So behind the shoulders, in the back buttocks, back of the hairline, in the neck, those areas behind the ears, it's almost impossible for a person to see the redness

if it develops because it's just in a place where we can't see it. Sounds like we should be on tick patrol more often in the summer. Thank you very much for speaking with us. Thank you very much for having me. Dr. Mirabelle Kelly is a medical microbiologist and infectious disease specialist

at the Granby Hospital and Brome-Missisquoi hospitals in Quebec. You've been listening to The Current Podcast. My name is Matt Galloway. Thanks for listening. I'll talk to you soon. For more CBC podcasts, go to The Current Podcast. My name is Matt Galloway. Thanks for listening. I'll talk to you soon.