Borreliose-Gesellschaft e.V.

de

Canadian Perspectives on Lyme Borreliosis
Janet Sperling1, Marianne Middelveen2, Douglas Klein3, Felix Sperling4

1 Department of Biological Sciences University of Alberta and Canadian Lyme Disease Foundation
2 Canadian Lyme Disease Foundation
3 Department of Family Medicine University of Alberta
4 Department of Biological Sciences, University of Alberta.

Lyme borreliosis is emerging as a serious public health risk in Canada with documented cases in every province. The use of dogs as sentinel species clearly shows that contact with Lyme borreliae, as detected by C6 peptide, extends across the country. Dissemination of Borrelia infected ticks by migratory birds and rapid establishment of significant levels of infection have been well described and yet controversy over diagnosis and treatment for humans has resulted in a polarization of views and potential under-recognition of the risk of Lyme borreliosis in Canada. Accurate Canadian statistics are difficult to obtain and clinical cases of early Lyme are not well captured in Canadian statistics.
The disease only became nationally notifiable in 2010 and it remains unclear whether such manda-tory notification will help or hinder the willingness of physicians to make a clinical diagnosis. Cana-dian Public Health response has focused on identification of established populations of Ixodes scapularis and Ix. pacificus, on the assumption that these are the only important vectors of the disease across Canada.
Strains of Borrelia circulating in Canada and the full range of their reservoir species and coinfections remain to be explored. Ongoing surveys and historical records demonstrate that Borrelia-positive Ixodes species are regularly present in regions of Canada, such as Alberta, that have previously been considered to be outside of the ranges of these species in recent modeling efforts.
We present data demonstrating that human cases of Lyme borreliosis are likely to be found across the nation and that improved early diagnosis is needed to prevent long term sequelae. Physician education and international cooperation is paramount for development of improved Canadian guidelines that recognize the complexity and diversity of Lyme borreliosis.

Janet Sperling is an entomologist trained at the University of Alberta, where she received her M.Sc. degree in 1988 with work on the neurophysiology of taste receptors in beetles. She continues her work at the same university with Professor Felix Sperling (Biological Sciences at the University of Alberta). Together, they have recently published an invited review: ôLyme borreliosis in Canada: biological diversity and diagnostic complexity from an entomological perspective. The Canadian Entomologist 141: 521-549.ö  She continues to be involved in research on Lyme borreliosis with particular interest in government policy as well as immunological and microbiological aspects of the disease. She is a board member of the Canadian Lyme Disease Foundation and is on the governing board of the Itaska Audubon Society.