This document provides information about ticks and Lyme disease. It discusses the different species of ticks found in Canada and their ability to transmit Lyme disease and other infections. It also summarizes two scientific studies. The first study models the expected expansion of the range of blacklegged ticks in Canada and the increased risk of Lyme disease. The second study finds evidence that songbirds can disperse ticks infected with Lyme disease over long distances, potentially starting new endemic populations. The document also provides background information on Borrelia burgdorferi, the bacteria that causes Lyme disease.

1. A Lyme & Other Tick-Borne Disease
Survival Guide
Pests
Protection/Education
& Politics
CanLyme, LAG, LDAO, ILADS, Murakami

2. Bulletin EVENTS:
Lyme/Walk Brampton ON, May 19th 2012 in
Chingaucousy Park on May 19, 2012 from 11
a.m.–2 p.m.
Registration forms available at
www.lymewalkbrampton.ca
Mark your calendars!

3. LDAO Spring Meeting – Sat. May 5, 2012
The Fireside Room
Compass Point Bible Church
Kerns Campus, 1500 Kerns Rd., Burlington
1:30pm - 3:30pm
Speaker - John Scott
Songbirds Disperse Lyme Disease Vector Ticks
Across Canada
John will be presenting the power point presentation
that he gave at the ILADS Conference in Toronto last
October; based on his recently published scientific
article.

4. MAY is Lyme Disease Awareness Month
Town of Caledon
Month of May as “Lyme Disease Awareness Month
2012”
Thanks to the support from Patti Foley, Regional
Councillor Ward 5 for Bolton.
Brampton
May 2012 will be declared “Lyme Awareness Month”!

5. Lyme Action Group
Advocacy – improved public policy
Public awareness
Not-for-profit
Patient group
A.K.A - LAG

6. Canadian Lyme Disease Foundation
Federally registered charity
Promoting
● Research
● Education
● Diagnosis
● Treatment
Current goal
● Fund pathology research defining true prevalence in
Canada
A.K.A - CanLyme

7. Lyme Disease Association of Ontario
Support / information to Lyme patients & family
Public awareness
Conduct/publish research in scientific journals
Non-Profit Charitable Org
Next meeting in Burlington on May 5th 2012
A.K.A – LDAO

8. International Lyme and Associated Diseases
Society
• Non-profit, international, multi-disciplinary
medical society
• Forum for health science professionals to share
their wealth of knowledge
• Provides informational exchange amongst
physicians who treat Lyme and other tick-borne
diseases
• Dedicated to diagnosis & appropriate treatment
of Lyme & associated diseases

9. • Advocate of and strongly supports physicians &
health care professionals engaged in such
treatment
• Research and education
A.K.A - ILADS

10. Dr. E. Murakami Centre for Lyme
Research, Education & Assistance Society
• Not-for-profit Corporation with charitable status
• Provides unbiased, double blind, peer reviewed facts
on Lyme and Co-Infections to those who need to
know; doctors and patients alike.
• Educates the people in the Medical Community
• Supports Lyme patients and families
• Works with governing bodies and assists in making
permanent changes to our existing protocols for the
diagnosis and treatment plans for Lyme in Canada.

11. • Dr. Murakami is a true hero for the Lyme
community and travels across Canada to
educate the Public, Physicians & Natural
Practitioners
• Dr. Murakami offers FREE advice to both
Physicians and patients alike:
Phone 1-604-869-992
or by email www.erniemurakami@hotmail.com

12. Pests
Info “bite” (pun intended) - 800 species of ticks have
been described - ticks occur with their hosts throughout
the world

13. Ticks in Canada
Deer Tick A.K.A Blacklegged Tick /Ixodes Scapularis
● Not all are infected with Borrelia
• Primary vector in Ontario
• A two-year life cycle
• Anti-freeze like compounds
in bodies and can be found
all year long...
including wintertime
● Also vector of Babesia, Ehrlichia, Bartonella

14. Blacklegged Tick as a Nymph; the size most likely
to infect you as you are less likely to see it

15. Western Blacklegged Tick Ixodes pacificus
Vector of:
• Lyme Disease
• Babesia
• Ehrlichia
• Bartonella

16. Lone Star Tick Amblyomma americanum
Vector of:
Female with
• Lyme disease also called white spot on
STARI or Masters‟ back
disease
• Ehrlichia
• Q Fever
• Tick Paralysis
• Tularemia
• Bartonella
Male

17. American Dog Tick Dermacentor Variabilis
Vector of:
• Rocky Mountain Spotted Fever
• Ehrlichia
• Tick Paralysis Female
• Tularemia
• Bartonella
Male

18. Rocky Mountain Wood Tick
Dermacentor Andersoni.
Vector of:
• Colorado Tick Fever
• Q Fever
• Rocky Mountain Spotted
Fever
• Tick Paralysis
• Tularemia
• Bartonella

19. This and Dermacentor Variabilis (2 previous
slides) have been shown to carry Lyme but
it is still under study as to their ability to
pass it on to humans3.
Dermacentor ticks may attempt to feed on an infected host
(mouse, bird, etc.) enough to become infected with Lyme
but be shooed off before the feed is complete. They then
may complete their feed on a human host so it is theorized
that there may be some level of transmission to humans
by Dermacentor ticks.

20. Brown Dog Tick - Rhipicephalus Sanguineus
Vector of:
• Q Fever
• Bartonella
Shown to transmit Rocky Mountain Spotted
Fever to humans.
 Shown to carry Lyme but it is still under
study as to their ability to pass it on to
humans3

21. Ixodes Angustus - a competent vector in
experiment2.
Ixodes dammini - it was shown to be the same
species as Ixodes scapularis in 1993.
Ixodes spinipalpis is implicated as a vector as well.
Ixodes muris has shown to be a weak vector of
Lyme disease and more research is needed.
Even soft shell ticks can transmit borreliosis to
humans

22. • Ixodes spinipalpis - implicated as a vector
• Ixodes muris – shown as a weak vector of LD
• More research is needed
• Even soft shell ticks can transmit borreliosis
to humans1 (CanLyme)
Not enough research being conducted in Canada
ANY Tick bite could be a serious
life changing event

23. *Download from www.lymeontario.org
New Research - 1
Journal of Applied Ecology doi: 10.1111/j.1365-2664.2012.02112.x
Predicting the speed of tick invasion: an
empirical model of range expansion for the
Lyme disease vector Ixodes scapularis in
Canada Patrick A. Leighton1*
Jules K. Koffi 2 - Yann Pelcat 2
Nicholas H. Ogden 1,2
L. Robbin Lindsay3
1 = Faculty of Veterinary Medicine, University of Montre´ al, 3200
Sicotte, C.P. 5000, Saint-Hyacinthe, QC J2S 7C6, Canada;
2 = Centre for Food-borne, Environmental and Zoonotic Infectious
Diseases, Public Health Agency of Canada, Saint-Hyacinthe, QC, Canada;
and
3 = Zoonoses and Special Pathogens Division, Public Health Agency of
Canada, National Microbiology Laboratory, Winnipeg, MB, Canada

24. Summary Points :
• Previously projected range increases for
I. scapularis based on temperature
suitability, but to what extent this is
matched by actual tick range expansion is
unknown.
I. Scapularis - Single tick species

25. • Model projections suggest that
I. scapularis range will expand c. 46 km/
year in the coming decade, with climate
warming expected to increase the rate of
spread. This expansion is likely to result
in a substantial increase in human Lyme
disease risk, with the proportion of the
human population of eastern Canada
inhabiting areas with established tick
populations increasing from 18% in 2010
to over 80%by 2020.

26. • Pg.2 (excerpt) No study has sought or
provided empirical support for the
influence of either long or short
distance dispersal mechanisms on the
pattern of I. scapularis invasion
excludes research by
John D. Scott et al from 1994 to
2012 & other scientific researchers

27. • Pg. 7 (excerpt) Establishment and
growth of tick populations across
southern Canada, where human
populations are concentrated, is
likely to result in a steep increase
in human contact with ticks
carrying Lyme disease and other
tick-borne diseases.

28. What Is Missing?
• Not looking at other vectors-I. scapularis
• Not looking at other hosts e.g. coyote,
wolf, certain bird species, human
• Not looking at other means of
transmission e.g. congenital, neonatal
(breastfeeding), sexual, blood etc
• Relying on faulty testing to determine
risk and partial infection rates due to
faulty statistics based on positive tests
only.

29. Where is the public and medical
society‟s education on the
“other tick-borne diseases”?

30. New Research - 2
J. Parasitol., 98(1), 2012, pp. 49–59 F American Society of Parasitologists 2012
WIDESPREAD DISPERSAL OF BORRELIA
BURGDORFERI–INFECTED TICKS
COLLECTED FROM SONGBIRDS ACROSS
CANADA
John D. Scott, John F. Anderson*, and Lance A. Durden - Research
Division, Lyme Disease Association of Ontario, 365 St. David St.
South, Fergus, Ontario, Canada N1M 2L7. e-mail: jkscott@bserv.com

31. Summary Points:
• Tested12 known tick species and 3
undetermined tick species
Ixodes affinis is reported in Canada
for the first time
Ixodes auritulus for the initial time
in the Yukon
• Ticks sampled from 42 bird species /
subspecies

32. • First records of 3 tick species
co-feeding on bird species
• New records of tick hosts; 2 bird
species
• The presence of B. burgdorferi in
Ixodes larvae suggests reservoir
competency in 9 bird species

33. • Study results suggest that songbirds
infested with B. burgdorferi – infected
ticks have the potential to start new tick
populations endemic for Lyme disease.
• Songbirds have the propensity for short
and long distance dispersal of attached
ticks
(Anderson and Magnarelli, 1984; Scott et al 2001; Reed et al 2003; hamer et
al 2011)

34. Because songbirds disperse
B. burgdorferi-infected ticks outside their anticipated
range, health-care providers are advised that people
can contract Lyme disease locally without any
history of travel

35. History
1883 – described in medical literature
1921 – speculation about blacklegged tick
involvement
1975 – outbreak in Lyme, CT
1981 – Dr. Willy Burgdorfer
– Isolated bacteria under microscope
– Borrelia Burgdorferi

36. About Spirochetes
• Over *300 different species are identified
• Lyme causing spirochetes are “Borrelia”
• 37 species of Borrelia
spirochetes have been
discovered
• about 12 are associated with the
condition known as Lyme
disease or borreliosis (Niscigorska-
Olsen and others 2008). “Healing Lyme” by Stephen
Harrod Buhner

37. The Bacteria “Borrelia Burgdorferi”
Borrelia - Survival Forms:
• Spirochete
• Cyst / Blebs/ Biofilm
• Cell Wall Deficient
Borrelia Cyst Form
Spirochete

38. Bacteria
Real-time high resolution imaging (U Calgary, 2008)

39. Bacteria
Image 2 of 3 (bacteria exits blood vessel)

40. Bacteria
Image 3 of 3 (bacteria in surrounding tissue)

42. About Borrelia Spirochetes
• 3 main Lyme causing Borrelia
• Burgdorferi – primary to USA / Canada.
* There are over 100 strains in the US ILADS
• Afzelii and Garinii – primary to Europe & Asia
NOTE: ALL 3 exist on all 3 continents
And multiple infections are common

43. •9+ other B species cause “Lyme-type infection” again
with numerous sub-species
• ALL grouped as “Borrelia burgdorferi sensu lato”
= in the broad sense.
•Do not like blood environment = oxygen

44. Like highly viscous mediums
• collagenous tissues
• aqueous humor of the eye
• organs such as the brain, heart
bladder
• synovial fluid of joints
• the central nervous system
(convert to cyst within 24 hr)

45. • Slow reproduction = doubling in 12-24hr
Since most antibiotics kill bacteria only
when they are dividing, this longer
doubling time necessitates the use of
relatively longer treatment courses for
Lyme disease

46. • Can alter geno-type so offspring are
better adapted to survive in new host
• Long life span
• Very hard to grow in laboratories; hard
to research
• The largest DNA replicons of any known
bacteria

47. Researchers at Rocky Mountain Laboratories where Dr.
Burgdorfer discovered B burgdorferi 2001 report:
that it contains at least six times as many genes as
that of Treponema pallidum, the spirochete which
causes syphilis

48. • Findings of Casjens et al 2000 helped to
explain decades of studies which have
shown that mammals, whether human or
animal, are unable to eradicate the
spirochete even if their immune systems
are completely intact
Studies: Liang et al 2004a,
Liang et al 2004b, Liang et al 2002,
Seiler and Weis 1996, Dattwyler et al
1989

49. How Borrelia Thrives and Persists
• Ticksaliva inactivates our complement
system the “innate immune system”
borrelia use this weakened defense to
invade host
 enhanced further if host is
already immune compromised

50. Lyme spirochetes determine host DNA from
tick‟s blood meal, weave the DNA into their
structure and from that DNA determine how to
alter physiologically to survive host immune
system.

51. • Known as a “stealth pathogen” can exchange
surface outer protein for another, quickly and often, to
evade the immune system and pathophysiological
mechanisms
“B burgdorferi, the principal organism associated
with Lyme borreliosis, is one of the most complex
bacteria known to man.”

52.  as the immune system or antibiotics,
recognizes & targets them
they change
with the same effect as a criminal
changing appearance or clothing to
avoid identification by police.

53. • Highly sensitive to tiny chemical shifts
• Good for them – food, sugars, fats
• Bad for them – High oxygen
concentrations
 So sensitive they can sense if a tick
feeds on a host they are present in and
if that tick is not infected they will go
into blood stream and quickly relocate
to new tick bite site

54. Organism can burrow into and between healthy
body cells, especially in the connective tissues
of the joints, and thus evade detection and
destruction by the immune system and
antibiotics.

55. • Can identify and adhere to different
kinds of cells in host; specific ones to
help them move to their preferred
sites e.g. Moving to areas high in
collagen (which they love) like joints,
aqueous humor of the eyes, meninges
of the brain, skin, heart tissue
• They exchange information with each
other

56. They Hide in the Lymph Nodes
Professor Nicole Baumgarth, an authority on immune responses at the UC
Davis Center for Comparative Medicine.
"At first it seems counter intuitive that an infectious
organism would choose to migrate to the lymph nodes
where it would automatically trigger an immune
response in the host animal, but B. burgdorferi have
apparently struck an intricate balance that allows the
bacteria to both provoke and elude the animal's immune
response."

57. • During growth, L spirochetes shed “blebs”
Blebs = granules of DNA plasmids
• These blebs bind circulating IgM antibodies &
help evade immune detection
 like a plane releasing a spray of metal
fragments to confuse radar readings.

58. Blebs are then taken up by different human cells
Then CD8 cells actively kill those cells
Causing speculation as to the autoimmune
aspects of Lyme borreliosis

59. IMPORTANT
Testing for Babesia, Anaplasma (a rickettsial
bacterium), Ehrlichia and Bartonella (other tick-
transmitted organisms) should be performed
The presence of co-infection with these organisms points
to probable infection with the Lyme spirochete as well
If these co-infections are left untreated, their continued
presence increases morbidity and prevents successful
treatment of Lyme disease

60. Other Transmission
Lyme spirochetes have been found in:
• biting flies, mites, fleas and, mosquitos
• breast milk, tears, urine, semen, vaginal
fluids
OTHER tick-borne infections have been
found to be transmitted via blood transfusions

61. “The data demonstrate that B. burgdorferi can survive the
blood processing procedures normally applied to transfused
blood in the USA. Since hematogenous spread of the
spirochete seems to occur early in the illness, primarily in
symptomatic patients, the risk of transfusion-associated
Lyme disease may be small. However, the possibility of
survival of B. burgdorferi under blood banking conditions
warrants a heightened awareness of this potential problem.”
Borrelia burgdorferi: survival in experimentally infected human blood processed for transfusion.
Source
Meningitis and Special Pathogens Branch, Centers for Disease Control, Atlanta, Georgia 30333.

62. Documented
From biting flies (Connecticut and Germany)
From mites (Russia)
It is considered to have occurred from mosquitos
through mechanical transfer e.g. squashing a feeding
mosquito
References in “Healing Lyme”
Safe sex is advised

63. New study highlights need for additional research on sex
based differences in the effects
of early Lyme disease.
Study showed
• Numerous symptoms reported more often
by women than men
• Women were less likely to seroconvert on
the antibody tests
Study suggests
• An immunological variation in response to
Borrelia burgdorferi between women and men
Lauren A. Crowder, M.P.H of the Lyme Disease Research Foundation, Luthervill
MD

64. Dr Murakami states that men tend to
remain asymptomatic and may in fact
be
infected more than once
before becoming symptomatic

65. Protection

66. Protection
Keep property grass cut short
Walk in center of pathways if available
Awareness of habitat (long grass, marshes)
Established host populations e.g.
deer, birds, rodents, coyote, rabbits

67. "We sat on logs for only five minutes at a time, and in 30
percent of the cases, it resulted in exposure to ticks," said
Robert Lane, professor in the Division of Insect Biology
at UC Berkeley's College of Natural Resources and lead
investigator of the study. "It didn't matter if we sat on
moss or the bare surface; the ticks were all over the log
surface. The next riskiest behavior was gathering
wood, followed by sitting against trees, which resulted in
tick exposure 23 and 17 percent of the
time, respectively."
The study, published in the current issue of the Journal of Medical Entomology, is the first
quantitative analysis of human behaviors that may increase the risk of tick exposure in California's
hardwood forests

68. • Wear light-coloured clothing, long
sleeves, pants tucked in, closed
footwear
• DEET-containing repellants or bio-
friendly alternatives BioUD,
Picaridin.
• Wash & dry clothing – Dryer on high
heat one 1hour

69. Tick check!
A full body examination
including
armpits, hairline, ears, navel,
groin area, behind the
knees, in between toes
Especially children!

70. Natural Options
• “Mosquito Barrier” yard spray
or similar product
(made from concentrated garlic)
• A DIY personal spray mix made from a blend of essential
oils e.g.
lavender, citronella, cedar, eucalyptus, peppermint, lemon
grass, rose geranium in almond oil & neem oil base.

71. • Theraneem Organix “Neem Oil for Garden”
sold at health food stores
or online
• Theraneem Organix
“Herbal Outdoor Spray”
Personal bug repellent
• Pine Tar Soap – shavings in a spray bottle with
warm water & shake until dissolved

72. Plants:
• Lavender
• Citronella
• Rosemary
• Sage
• Catnip
• Pennyroyal
• Rose Geranium
• Mexican Marigolds
• Marigolds
• Calendula
• and then Borage, chrysanthemums, cosmos,
rue, and sunflowers are general pest repellant
flowers

73. Tick Removal
DO NOT
remove an attached tick using:
Vaseline
Nail polish
Hot match / flame
Ointment – Or other caustic fluid
DO NOT squeeze the tick body
Doing any of the above will cause the tick to
regurgitate its gut contents

74. Safe Tick Removal
Fine Point Tweezers
Grip head/mouthpiece firmly snug against skin
Pull straight out – do not twist
Ensure mouthpart is out
Make note of:
– Date/time
– Where on the body
– Area of outdoor activity

75. Tick‟s Mouthpart / Hypostome

76. Un-engorged
Blacklegged Tick
Female Blacklegged Tick
feeding
Engorged Blacklegged Tick

77. Safe Tick Removal
Intradermal blister technique
● Developed by Canadian Doctor Ernie Murakami of
Murakami Centre for Lyme in BC
● Only in doctor's office
Available to watch on youtube

78. STRAW AND KNOT METHOD
Developed by Dr. Murakami
1) Ordinary drinking straw
place it at a 45 degree angle with one open end over the tick (the
straw is simply being used as a guide to direct the knot)
2) Next, take a length of thread and tie a loose knot at
the top or midsection of the straw.
3) Slide your knot down the straw to the site. Position
the knot underneath the tick's belly, so that the knot
will encircle the embedded part only.
4) Slowly tighten the knot to close snugly around the jaws
5) Remove the straw and pull the thread in a steady
upward motion. This will cause the tick to detach,
without regurgitation.
Available to watch on youtube.

79. Safe Tick Removal
Specialized removal tools
● Camping supply stores
Save tick for testing!!

80. Save Tick For Testing!
• Best option is a Physician removing tick
• If you remove a tick – save it in an old pill
bottle with a damp piece of paper towel
• Either – Bring it to your Physician
- Bring it to the Public Health Dept
It will be sent to the Parasitologist, Central
Laboratory, 81 Resources Rd., Etobicoke ON M9P
3T1
* Request that it be tested for Borrelia
and other tick-borne pathogens

81. Document Bite
Photograph a rash if present
● Include ruler
● Successive days to show expansion
● Seek medical attention
● Watch for subsequent rashes

82. Rash
Less than 50% have rash;
• 30-50% in Adults
• Less than 10% of children
• Sometimes single rash
• Sometimes multiple rashes
• Sometimes subsequent rashes months to
years later
Atypical and Typical rash formations

83. Typical Formation
Bulls-eye
• Only 9% of rashes are the “bulls-eye” type
• Red circumference with central clearing
• Often starts in 3-30 days – may start weeks to
months later
• Gradually expands and eventually disappears
• Sometimes warm to touch

84. Homogeneous
• Has uniform reddish colour
• Expands as Bb infection spreads
• More people have this type than the bulls-eye

85. Atypical Formation
• Slides A & B
• Multiple blotchy
• Occur later as
secondary rashes
• Indicates dissemination
of Bb
•Slide C
Painless bluish-red
swelling or nodule on ear
(more common in Europe)

86. •Slide D – Acrodermatitis chronica atrophicans
(ACA)
• Bluish-red inflammatory lesions on
extremities: buttocks, limbs, hands etc.
• Develops slowly with wasting of skin
(atrophy)
Rash - Like hives (Not Shown)

87. Fast Facts
• Lyme is fastest growing
vector- borne disease
• 85% do not recall tick bite

88. Some Early Symptoms
Rash, variety (less than half of patients)
Flu-like illness (fever, chills, sweats, muscles aches,
fatigue, nausea and joint pain) followed by
intermittent illness
Ringing ears, tremors, pain, arthritis, stiff neck,
headache
Sudden unexplained change in health
Bell‟s palsy
Lab tests may be negative in the first 4-6 weeks
Antibiotics can cause a false negative result

89. Lyme Symptoms
Joints and Musculoskeletal Symptoms
Joint pain and/or swelling
Stiffness of joints, back, neck
Muscle pain, cramps
Headache, persistent and severe
Jaw pain
Neurological Symptoms
Twitching of facial or other muscles
Numbness and tingling
Weakness or partial paralysis
Light-headedness or dizziness
Poor balance, difficulty walking
Burning and stabbing pains

90. Neurological Symptoms continued
Restless legs
Memory loss (short or long term)
Confusion (difficulty with thinking)
Speech difficulty (slurred or slow, word finding)
Seizures/stroke symptoms
Blurry or double vision, sight change
Sensitivity to light and flashing lights
Sound sensitivity
Tinnitus (ringing)

91. Psychological Symptoms
Mood swings, irritability
Unusual depression
Panic/anxiety attacks
Aggression/rage
Obsessive-compulsive behavior
Paranoia
Suicidal thoughts

92. Respiratory/Circulatory Symptoms
Recurring bronchial infections
Shortness of breath
Chest pain/rib soreness
Heart palpitations, murmurs, valve prolapse, heart
attack

93. Other Symptoms
Insomnia or sleeping too much
Night sweats or chills
Swollen/painful lymph glands
Loss of sex drive
Chemical sensitivity/increased allergic reactions
Sore throat
Weight gain/loss
Skin changes/nodules under the skin, dryness
Full lists available in LDAO brochure
www.canlyme.com & www.ilads.org

94. Fast Facts
•25% of Lyme patients are children
•50% have no history of tick attachment

95. Children
• Young children may not be able to
explain what they are feeling
• Children born with tick-borne infections
(AKA congenital, in utero, transplacental)
OR infection acquired as a neonatal, may not
recognize symptoms as “abnormal”

96. For example:
If your knees have always hurt, you really
don‟t know what it means for them NOT to

97. Some “Red Flags” For Chronic Disseminated
Lyme Disease & Other Tick-Borne Infections In
Children
• Frequent visits to Dr; has many, varied complaints
• Symptoms that have eluded diagnosis
• A high number of school absences
• Is sick frequently, “comes down with everything
that goes around”
suspect immune suppression due to chronic
infection

98. • Sudden changes of behavior; quiet child
has become loud and aggressive, active
child has become passive, happy child
has become weepy and sad, calm child
has started throwing fits and tantrums

99. • A history of such diagnoses as
• juvenile rheumatoid arthritis (JRA)
• hypercholesterolemia
• migraines
• Crohn‟s disease
• gastritis
• maturation delay
•Autism
• attention deficit/hyperactivity disorder
(ADHD) and learning disabilities.
 especially a previous diagnosis of JRA if
the child has also been diagnosed with
ADHD and/or migraines.

100. Child has history of symptoms that do not neatly fit
into any diagnostic category:
• Low energy in the absence of anemia
• Frequent urination in the absence of a
urinary tract infection
• Visual problems with a normal
ophthalmologic exam

101. • Stomach pains, vomiting and abdominal
cramping without obvious pathology
• Frequent fevers OR low body temp
• Clumsiness
• Frequent “growing pains” without
typical symptoms
• Insomnia unresponsive to the usual
treatments

102. Nurse/Dr „s Exam – May Notice
• A tendency towards distractibility /
hyperactivity
• It is often difficult to get the child to
stop talking or sit still long enough for
vital signs to be taken
• The child may be hypersensitive to
touch and may wince when the blood
pressure is taken

103. • May avert their eyes to the light of
an opthalmoscope or complain that
the lights in the room are too bright
• Reflexes may be so brisk that even
brushing against the leg will cause
the child‟s lower leg to kick forward

104. Lyme Patients in General
Become more vulnerable to other infections and
health issues like:
Mycoplasma, Brucelliosis, Leptospirosis, Yeast
(Candida), Epstein Barr virus, H. Pylori, Chlamydia
pneumoniae, Mold, Mercury toxicity....and more

105. The exact role that other tick-borne
diseases and opportunistic illnesses
play in the disease course is poorly
understood, and known treatment
options are not always effective.

106. Misdiagnosis
1.5 million Canadians suffer from diseases of
unknown origin (Health Canada – Stats Can 2010
CCHS) e.g.
● Arthritis
● Fibromyalgia / Chronic Fatigue
● Multiple Sclerosis (MS)
● Lou Gehrig's Disease (ALS)
● Alzheimer's
● Parkinson's
● Crohn's
● Autism

107. Don't waste time (Canada) Testing
● PHAC Guidelines recommend treatment even in
absence of lab confirmation
● Flawed 2-tier protocol (ELISA / Western Blot)
● ELISA false negative results common; 4-65%
accuracy has been reported
● New C6-Peptide but still with B31 Western Blot
 in 25 years only B burgdorferi strain B31 has being tested
for in humans

108. • Specialized, accredited tick-borne illness labs
(USA) with a good quality Western blot
include:
• IGeneX.com(California)
• Glongen.com
• mdlab.com (Medial Diagnostics Lab)
Request free test kit & bring to Dr for
blood requisition then overnight courier
blood to lab with payment

109. Why?
Untreated Lyme is...
● Debilitating
● Degenerative
Best outcome from...
● Early diagnosis
● Prompt treatment

110. Cases on the Rise (USA)
Annual reported cases (CDC)

111. Infections (USA)
Reported Cases (CDC, 2010)

112. Cases on the Rise (Ontario)
Annual reported cases (Ont. Ministry of Health)

113. Tick Prevalence (Canada)
Ticks per human population (CMAJ, 2009)

114. World Health Organization Global Prevalence Map
Areas infested with Lyme disease (in red) are north and south of
the 49th parallel.
Note that Alaska, which is more northerly than most
of Canada, is completely red, stretching below the
49th parallel and into the United States.

115. Eurosurveillance Global Incidence Graph
International studies of incidence of Lyme disease per 100,000
• Canada is 0.115 per 100,000, contrasted with 36
per 100,000 for Czech Republic which is on a
similar latitude as Canada
• Canada averages about 6 cases per year, per
province by the ELISA test, yet across the border
every north central, north eastern states reports
an average of 1,000 cases annually.

116. Risk of Infection (USA)
Infected tick populations (Yale Public Health, 2006)
Map shows a sharp
demarcation of diminished
Lyme disease by the ELISA
test
Canada = 2 cases per million; total of about 80 cases in
2008 per Public Health Agency Canada
Immediately across the border 49th parallel
there is in the USA, 70 cases per million

117. Disease Comparison (USA)
Approximate annual cases (CDC)
West Nile Lyme Aids

118. The US CDC has recently published 2008 cases of Lyme
disease
35,198 reported
422,376 estimated actual cases
(using an error factor of 12x)
It is a well known fact that when the US has 422,376 cases
then Canada will have approximately 10% yet only 80
cases are reported for the year 2008 by Public Health
Agency of Canada.
The estimated actual cases in Canada must be over 40,000
(Dr. Murakami)

119. Disease Comparison (USA)
Approximate annual cases (CDC)
Due to faulty
tests, actual Lyme
cases estimated at
400,000 cases per
year
*Most endemic
States border
Canada
West Nile Lyme Aids

120. Politics

121. IDSA
Infectious Diseases Society of America
● Treatment guidelines, 2006
● Chronic Lyme doesn't exist (Post Lyme Syndrome)
Antitrust investigation, 2008
● Conflicts of interest
New guidelines review, 2009
2006 guidelines upheld, 2010

122. “Cure Unwanted?
Exploring the Chronic Lyme Disease Controversy
and Why Conflicts of Interest in Practice Guidelines
May Be Guiding Us Down The Wrong Path”
American Journal of Law & Medicine 2012
The American Journal of Law and Medicine has
stepped up and voiced their opinion on the
situation surrounding Lyme and Chronic Lyme
and faulty guidelines etc.

123. AJLM Re: Antitrust investigation, initiated by
Richard Blumenthal, 2008
• Findings deeply troubling
• IDSA failed to conduct screening
process for conflict of interest for its
(Lyme) panel members
• Pervasive conflicts of interest

124. • Authors of guidelines had significant
connections to drug companies,
related patents and Lyme diagnostic
tests
• Several authors were paid by
Insurance companies to corroborate
treatment plans that denied treatment
for chronic Lyme disease

125. • Some received fees for acting as
expert witnesses in medical malpractice
suits related to Lyme disease
 All stood to gain financially if the
narrow definition of Lyme disease
remained the same

126. • IDSA acted with conflict of interest by
enabling the panel chairperson (who
himself held a bias against the existence
of Lyme disease) to select a like-minded
panel
 without any scrutiny by the IDSA
oversight committee

127. • Panel refused to accept potential
panelists who believed in the existence of
chronic Lyme disease – these panelists
were told the panel was full - then the
panel was later expanded
• Panel excluded evidence of chronic Lyme
disease

128. Legislative Solutions
Lyme doctor protection
● California
● New York
● Rhode Island
● Connecticut
● Minnesota
● Massachusetts
No such protection in Canada
(or other US States)

129. Canadian Experience
Doctors persecuted for treating Chronic Lyme
● Dr. P. Williams, 2004 (Ajax, ON)
● Dr. E. Murakami, 2008 (Hope, BC)
– More than 20 patients out of “permanent”
wheelchairs
● Dr. J. Krop, 2010 (Mississauga, ON)
● Dr. H. Baghdadlian, 2011 (Toronto, ON)
Common themes
● Patient outcome is not a factor
● Doctors put license at risk for treating Chronic Lyme

130. Vancouver, British Columbia
Marketwire – Jan. 20, 2008
Canadian Lyme Disease Foundation: Feds say
„NO‟ to access of Freedom of Information
Request on Serious Health Matter; National
Security Cited

131. Positive Developments
Lyme and Tick-Borne Disease Research Center, Columbia
U. Med. Center, NY (2007)
Lyme Action Group (2008)
Anonymous $0.5 million donation to CanLyme (2009)
Dr. E. Murakami Lyme Society (2009)
Ontario government Lyme awareness campaign (2010)
New support groups taking political action

132. Lyme Awareness (Ontario)
Campaign fails to address flawed testing protocol
Fails to warn of all tick dangers
Fails to inform re: Alternate transmissions
“Detected early, Lyme disease can be treated with
antibiotics, curing most cases. Untreated, Lyme
disease can begin to attack the central nervous
system, the brain or the heart.”

133. Lyme Awareness (Ontario)
Chatham Public Health and Rondeau Provincial Park
(2010)
● Blenheim, ON

134. Lyme Awareness (Ontario)
Public Health Ontario (April 2012)
● Update on Lyme Disease Prevention and Control
– What testing problem?
– Referenced outdated,
minimalistic & exclusionary
science
– Beware of US tests
– Chronic Lyme doesn't exist

135. Political Action
Lyme Action Group
● Ontario Ministry of Health
● Ontario Public Protection & Prevention
● Canadian Blood Services
● Ontario Ombudsman
CanLyme
● Federal Ministry of Health
● Public Health Agency of Canada
● National Microbiology Laboratory (Winnipeg, MB)

136. Local Action

137. Canadian Action
Schmidt Report, BC (2010) - on Chronic Lyme Disease in
British Columbia
Schmidt Report Shows: *Tests
are unreliable *Doctors not
trained
*Chronic Lyme being ignored
*New BC clinic announced
56-page document, obtained via FOI request by a
long-time Lyme sufferer.

138. Political Awareness
Sarnia-Lambton MPP Bob Bailey
● Petition to Ontario Legislature
● Endorsed by +100 municipalities
Nickel Belt MPP Frances Gélinas
● Wall of Hope, Queen's Park

139. Media Coverage

140. Books

141. Multi-Award Winning Documentary Film
• Exposes the hidden story of Lyme disease USA
• Controversies of this fast growing epidemic
• Thousands go undiagnosed or misdiagnosed
each year
• Follows the stories of patients and physicians
fighting for their lives and livelihoods
DVD copies available at www.underourskin.com

143. Conferences

144. A Lyme Disease Survival Guide
Be informed!
Be aware!
Be warned!
You are your own best advocate

145. A Lyme & Other Tick-Borne Disease
Survival Guide
Thank you!
Please visit us online
www.canlyme.com
www.lymeactiongroup.blogspot.com
www.lymeontario.org
www.ilads.org