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By Charlene MacKenzie

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HAMPTON - When the provincial Department of Health issued an advisory July 17 urging New Brunswickers to take precautions against tick-borne Lyme disease, Bob "Dewey" Doucet felt a little vindicated. He and other New Brunswickers have been trying for years to get provincial authorities to acknowledge the disease's threat is really here.

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Robert "Dewey" Doucet, a surveyor and a member of Hampton council, is one of the Kings County residents who knows first-hand the impact of Lyme disease.

Lyme disease is a bacterial infection transmitted by infected blacklegged ticks, commonly known as deer ticks. These tiny, insect-like mites feed on the blood of humans, pets, wildlife and birds. While feeding, ticks carrying the bacterium Borrelia burgdorferi may transmit it to their unsuspecting host.

The disease causes flu-like symptoms, fatigue, joint pain and in some cases a round "bull's eye" skin rash. If untreated, debilitating symptoms develop which may be misdiagnosed as autoimmune, neuromuscular or gastrointestinal diseases, or as psychiatric disorders.

Dr. Eilish Cleary, deputy chief medical officer with the New Brunswick Department of Health, said Lyme disease risk is still low in most parts of the province, "but it is still important to take appropriate precautions."

Like many Lyme disease sufferers, Doucet doesn't recall ever seeing a tick on himself. A government land surveyor, he often works in the conditions where ticks may lurk, in tall grass and dense brush. Like many others who work in the woods or fields, he was unaware danger could lurk there in the form of tiny mites.

Looking back through Doucet's medical file for clues, his doctor recalled treating him in 2001 for large red rashes in the armpit and groin areas.

"We treated it for heat rash and it went away, but a couple of years later, it hit me like a rock," Doucet said.

"It affected my whole life, and my family's life."

Before feeding, red and brown adult ticks are three to five millimetres long.

"Following a blood-meal, females can be as large as a grape," according to the Public Health Agency of Canada's Lyme disease fact sheet. Nymph ticks are smaller and lighter, about the size of a poppy seed.

Working with PHAC, the provincial health department has confirmed all three active stages of the blacklegged tick's life cycle (larva, nymphs and adults) have been found in New Brunswick.

The provincial advisory said "recent preliminary studies" indicate there are blacklegged tick populations in Millidgeville near Saint John. Lyme disease has been reported throughout North America as well as in parts of Europe and Asia and established populations of blacklegged ticks have been found in Ontario and parts of Nova Scotia.

"Research has shown that blacklegged ticks can be found in all areas of Canada, even where tick populations have not been previously identified," according to PHAC, which said ticks may have been introduced to these areas by migratory birds.

Symptoms

With early diagnosis, the disease is treatable with a few weeks of antibiotics. Early symptoms are flu-like: headache, fever, chills, fatigue, muscle and joint pain and swollen lymph nodes. Sometimes there's a circular "bull's eye" rash within the first days or weeks of infection.

Untreated, symptoms may worsen over several months to include central and peripheral nervous system disorders, skin rashes, arthritis and arthritic symptoms, heart palpitations, extreme fatigue and general weakness.

Unless treated, debilitating symptoms develop in the third, advanced stage of the disease.

"The third stage of the disease can last months to years with possible symptoms including chronic arthritis and neurological symptoms," the PHAC fact sheet states.

"If contracted during pregnancy, adverse effects on the fetus, including stillbirth, can occur. Fatalities from Lyme disease are rare. However, undiagnosed Lyme disease may develop into chronic disease that may be difficult to treat."

While last week's provincial advisory indicated early diagnosis and treatment usually result in full recovery, early diagnosis is a real problem in New Brunswick, Doucet said.

He was 43 in 2003 when he began experiencing mysterious symptoms of chronic and unexplained pain, muscle twitches, facial soreness and "brain fog." After testing him for a range of diseases including celiac disease, chronic arthritis and multiple sclerosis, his doctor was bewildered.

Lyme disease is commonly misdiagnosed, according to the Canadian Lyme Disease Foundation, which lists late-stage Lyme disease misdiagnoses on its website: fibromyalgia (chronic widespread pain), lupus, arthritis, heart disorders, Crohn's disease, multiple sclerosis, early amyotrophic lateral sclerosis (known as ALS or Lou Gehrig's disease), irritable bowel syndrome, gastroesophageal reflux disease, interstitial cystitis (urinary bladder disease), chronic fatigue syndrome, early Alzheimer's disease and bi-polar disorder.

Doucet wasn't tested for Lyme disease, he said, because the medical community and provincial authorities had no reason to suspect it there were no "documented" cases in the province.

Undocumented cases

Doucet learned Canada lags behind the United States in testing capacity. With the blood testing currently used in Canada, the majority of samples come back negative. Lab tests on recovered ticks are more successful and he advises people to send any ticks they find on themselves for testing.

PHAC warns blood tests may return negative for patients with early Lyme disease or whohave had antibiotic treatment. It also notes Lyme disease is not a nationally reported disease in Canada.

Earlier this month, the Canadian Lyme Disease Foundation held rallies in Kamloops, Vancouver, Edmonton, Winnipeg and Toronto focused on the issue of testing in Canada.

Like other New Brunswick Lyme disease sufferers tested in the United States, Doucet is an undocumented case in Canada because the diagnosis didn't come through the Canadian medical community.

Lack of efficient testing and diagnosis in Canada means New Brunswickers haven't been getting a true understanding of the scope and potential growth of the problem, he said.

Doucet said his doctor, while helpful, didn't want to be named in media coverage of Lyme disease since it involved a disease the medical community hadn't formally acknowledged in the province. Doucet knows of people who went to their doctors or waited months to see specialists, only to be denied assistance when they asked to be tested for Lyme disease.

Doucet was finally tested, for $300 US at his own expense, in California. Upon testing positive, he was put in contact with a Vancouver doctor for treatment and flew out at his own expense.

His Fredericton friend diagnosed in 2006 is being treated by a doctor in Maine who sees, on average, one New Brunswicker a day. That person is another undocumented case.

While several factors worked in Doucet's favour to eventually lead to diagnosis and treatment, many New Brunswickers don't have those opportunities, he said.

"I'm one of the lucky ones."

Protection/detection

The Department of Health lists preventative measures for anyone spending time outdoors this summer in wooded areas or tall grass:

- Wear enclosed shoes, tucked-in long-sleeved shirts with close-fitting wrist openings and long pants tucked into socks or boots to limit tick access to exposed skin.

- Apply insect repellents containing DEET to exposed skin and clothing.

- Check for ticks on clothing and skin after being in tick-prone areas. Light coloured clothing helps the wearer spot ticks. A total-body inspection and prompt removal of attached ticks within 18 to 24 hours can reduce the risk of infection.

- Check children and pets as well.

The provincial advisory provided instructions on what to do if a tick is found on the body, but in many cases an infected person may not recall seeing a tick because they are tiny and may feed and drop off the body undetected.

The department advises removing attached ticks with tweezers, grasping the head and mouth parts as close to the skin as possible and pulling slowly, without twisting or rotating, until the tick is removed. Wash the affected skin with soap and water and record the date and likely geographic location the tick was acquired.

The department advises seeing a doctor if symptoms of Lyme disease develop.

Doucet advises anyone finding a tick on themselves or someone else to save the tick for testing. Put the tick in a plastic baggie or pill container with a bit of wet paper towel to prevent it from drying out, and take it to a doctor, hospital or public health office to be sent for testing.