Ontarians heading outdoors this summer are likely well-versed on the potential risk of Lyme disease that comes with a tick bite.
But there are three other pathogens that can be transmitted by blacklegged ticks that public health officials want you to know about – and confirmed cases have already been reported in Ontario.
Last month, Public Health Ontario (PHO) released an enhanced epidemiological summary on anaplasmosis, babesiosis and Powassan virus, all three of which were designated as “diseases of public health significance” by the Ministry of Health on July 1 of 2023.
According to the report, last year there were 40 cases of anaplasmosis in Ontario (17 confirmed and 23 probable) and 15 cases of babesiosis (eight confirmed and seven probable). There were no reported cases of Powassan virus.
Most of the cases were reported in the summer months, with 16 cases of anaplasmosis and 10 cases of babesiosis logged in July.
PHO data shows that the majority of the anaplasmosis infections were reported by public health units in eastern Ontario, including Kingston-Frontenac and Lennox and Lexington (KFL&A Public Health), where between 13 and 15 cases were reported.
The babesiosis cases were more widespread, with at least two infections reported in Toronto.
But what are these diseases and how do they differ from Lyme disease?
CTV News Toronto spoke with Dr. Richard Mather, PHO’s public health physician lead for vector-borne diseases, to learn more about the pathogens creeping up in Ontario and how people can protect themselves.
Mather explained that during early infection, it’s hard to distinguish between anaplasmosis, babesiosis and Lyme disease, because all three can cause flu-like symptoms, including fevers, chills, muscle aches and a headache.
However, Mather said one “big difference” is that the characteristic bullseye-like rash that appears in 70 to 80 per cent of people infected with Lyme disease does not appear in individuals infected with anaplasmosis or babesiosis.
“Most people will have a mild illness, [which is] self limiting, so it will get better on its own without treatment, which is often within 30 days,” he said. “But for some people, they can have severe disease. Severe symptoms could include things including respiratory problems, bleeding problems, organ failure, or death.”
Groups that are at risk of severe outcomes following an anaplasmosis or babesiosis infection include older adults, immunocompromised individuals and those with a delayed diagnosis.
“Severe disease isn’t that common. Some estimates by the Public Health Agency of Canada say that five to seven per cent of [anaplasmosis] patients would require intensive care and the case fatality rate is estimated at 0.6 per cent.”
Due to the “overlapping symptoms,” Mather said the only way to determine which disease you may be infected with is through bloodwork at a medical facility.
If you do find a tick on you, you should remove it as soon as possible and make sure not to crush or damage it in the process.
“You want to grasp it with tweezers as close to the skin as possible, so you’re taking the whole tick off and not leaving part of it on your body. Wash the area with soap and water and monitor yourself for the signs and symptoms of these tick-borne diseases,” Mather said.
If you suspect a tick has been attached to your body for more than 24 hours, the minimum amount of time required for the transmission of Lyme disease, or you’re developing symptoms, Mather suggests contacting your local health-care to discuss potential for medication to prevent Lyme disease.
“Post-exposure prophylaxis (PEP) is available to prevent Lyme disease, but not currently recommended as a preventative medicine for those other diseases.”
If you suspect the tick has been attached for less than 24 hours, and you don’t have any symptoms, you don’t necessarily need to see a doctor, Mather said, but you should remove the tick right away and self-monitor.
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While Mather said he couldn’t speak to the specific reasons why anaplasmosis, babesiosis and Powasson virus were listed as diseases of public health significance by the Ontario’s health ministry last July, he said there has been an increase in the number of cases in areas surrounding Ontario.
“So because we know we have the ticks that can transmit these diseases in Ontario, and we are seeing increasing number of the diseases in the States or provinces around Ontario, we can anticipate there’ll be an increased number of cases of these diseases in future years,” he said.
Mather said PHO is expecting the areas in which blacklegged are found in Ontario to increase in the future, due to a number of factors, including climate change, the migration of animal host species as well as land use pattern changes, which will bring more people into contact with the arachnids.
Mather anticipates that the number of anaplasmosis and babesiosis cases reported at the end of this year will be higher than 2023, largely because there will be a full 12 months of data to pull from and more awareness about the pathogens.
So far, in 2024, Ontario has seen one case of babesiosis and no cases of anaplasmosis or Powassan virus. Meanwhile, 102 cases of Lyme disease have been confirmed. In 2023, there were 1,795 confirmed or probable cases of Lyme disease.
Officials say protecting yourself against anaplasmosis, babesiosis and Powassan virus comes down to prevention.
“Similar to Lyme disease, there’s no vaccine for these diseases. So the best way to avoid infection is to prevent a tick bite,” Mather said.
Ontarians are encouraged to wear light-coloured clothing, so it’s easier to see ticks, closed-toed shoes, long-sleeved shirts and long pants tucked into socks when entering a wooded area or an area with tall grass or bushes.
Using insect repellant is also recommended, but make sure it contains DEET or icaridin, and spray it on your clothes and exposed skin.
Once you get back indoors, check yourself and your children for ticks.
If you spot a tick on your clothing, throw those items in the dryer on high heat for at least 10 minutes before washing.
While the first case of anaplasmosis in Ontario was detected in 2018, there were 40 cases of the potentially life-threatening illness in 2023
As the black-legged tick population continues to grow in southern Ontario, reports of both Lyme disease and lesser-known anaplasmosis are increasing.
Both illnesses are being closely monitored by public health officials in Ontario, while other tick-borne illnesses, including babesiosis, a bacterial infection, and Powassan virus, a rare disease that causes encephalitis and severe illness, are also cause for concern.
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Anaplasmosis, if left untreated, can cause severe respiratory illness and be life-threatening, especially for those with compromised immune systems.
All three conditions were added to the province’s Health Protection and Promotion Act last July, and noted as diseases of public health significance. Here’s what to know.
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Anaplasmosis is caused by the bacteria Anaplasma phagocytophilum. Symptoms can include fever, severe headache, muscle aches, fatigue, nausea, cough and confusion.
Spread by black-legged ticks, it infects white blood cells in both animals and humans. Like Lyme disease, it is treated with antibiotics.
Black-legged ticks, also known as deer ticks, are often found in wooded and forested areas, especially areas with thick underbrush. They are also commonly found in tall grasses, including along trails and in fields, and areas with accumulated dead leaves.
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While the first case of anaplasmosis in Ontario was detected in 2018, there were 40 cases in 2023.
Eastern Ontario, in particular, is a hot spot for tick-borne illnesses. More generally, risk is highest in areas with established vector populations — the ticks that are capable of carrying and transmitting pathogens. This includes southwestern and northwestern Ontario, southern Quebec, southern Manitoba and Nova Scotia and New Brunswick.
Infection can occur at any time of year, but is more common in the warmer months, from April to September.
Symptoms generally appear a week or two weeks after the bite.
Ticks need about 12 to 24 hours to spread the bacteria that causes anaplasmosis, compared to at least 24 hours for Lyme disease.
While Lyme disease is marked by a circular rash, there is generally no rash with anaplasmosis.
Covering up is one of the best preventive measures, including tucking pants into socks, as well as applying insect repellent that contains DEET.
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Wearing light coloured clothing can make it easier to spot ticks and a full body check after coming inside, along with regular checks while outside, can help catch ticks before they have the chance to spread an infection.
If you find a tick, use clean tweezers to grasp the head as close to the skin as possible and pull the tick straight out with slow and steady pressure. Twisting or squeezing the tick can increase the chance of catching a tick-borne infection as the tick will expel its stomach contents.
It is recommended to report tick bites and submit ticks to public health authorities so they can track populations and the spread of disease.
Online tools and mobile apps like eTick.ca can also be used to help identify the tick.
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Physicians and researchers who specialize in dementia care and prevention say a new $30-million donation to seven Toronto hospitals and organizations will significantly bolster their programming.
And they say the money is coming at a crucial time — as the health-care system faces a rapidly aging population and growing needs.
The Slaight Family Foundation, a charity founded by media magnate Allan Straight, announced the large gift Tuesday.
Samir Sinha, director of health policy research at the National Institute on Ageing at Toronto Metropolitan University, says the number of Canadians with dementia is increasing.
He points to a 2022 study by the Alzheimer’s Society of Canada that estimates close to 1.7 million people will have dementia by 2050, believed to represent 3.6 per cent of the population. As of 2020, about 600,000 people in Canada had dementia, or about 1.6 per cent of the population.
That’s why this donation will be “transformative”, he said.
“The greatest risk factor for dementia is just age. The older you get, the higher the risk you’ll be living with dementia…so just by nature of our population aging, we’re going to see many more Canadians living with dementia,” he said.
According to the Alzheimer’s society, dementia is an overall term for the symptoms caused by brain disorders that can cause cognitive failures around thinking and memory. Alzheimer’s disease refers to a specific type of dementia that primarily impacts memory.
Some form of memory loss is normal for people over age 65. But to have your memory deteriorate to the point where you cannot take care of yourself, is abnormal, according to the society.
“This gift is really going to help people prevent dementia, but it’s also going to make sure that we can better support better ways of delivering care and conducting the research we need,” said Sinha.
The money will be doled out to seven organizations, including:
Alzheimer Society of Canada: $3 million
Baycrest: $9.5 million
Belmont House: $700,000
Centre for Addiction and Mental Health (CAMH): $6.5 million
Egale Canada: $3 million
National Institute on Ageing at TMU: $3 million
Sunnybrook Health Sciences Centre: $4.4 million
Sinha helped the foundation learn more about which organizations to give the money to. He says not only will it go toward treatment, it will also help with public education and awareness of how to recognize signs of dementia and assess brain health.
Terry Smith, the program director at the Slaight Foundation says the organization decided to make the donation because dementia is an illness that many people have experience with in their families.
“Quite frankly, there is not a lot of support for those living with dementia. It just is something we feel, if there’s something that can be done, then maybe the foundation can provide some support,” she said.
The institutions in Toronto are world-class and deserve to have more resources, she said.
Sinha says preventing dementia is a priority for the organizations using the funding. Too many people believe that dementia is a normal part of aging, when it’s not, he said.
“They don’t even know that there’s actually things they can do to prevent dementia from developing in the first place,” he said. Staying socially engaged, eating a well-balanced diet and getting consistent exercise can all help ward of the disease, he said.
The federal government has a national dementia strategy that was released in 2019.
The strategy explains that while dementia is not an inevitable part of aging, age is an “important risk factor” for the illness. The growing aging population in the country will increase the number of people living with dementia as a result, it says.
The impact of the illness on the health-care system is “significant” as there is no cure. Health-care costs for people with dementia are about three times higher compared to those without it, the report says.
Neil Vasdev, the scientific director of the brain health imaging centre at CAMH, says he and his team have been developing ways to identify early signs of dementia through brain scans.
They’ve been examining a protein called tau and other enzymes to see if they can be early indicators of Alzheimer’s, said Vasdev.
The donation CAMH is receiving is “critical,” he said. “Especially for Canada to continue to have a major role and lead the way,” he said.
Vasdev said CAMH and other health-care organizations continuously apply for grants and government funding. But those can take years to come through — and this donation will be helpful immediately.
The federal government’s dementia strategy says it’s providing $50 million over five years to the Dementia Strategic Fund, which is run by the Public Health Agency of Canada, toward government initiatives to prevent and find treatments for dementia. Organizations focused on dementia have also been able to apply for a portion of the funding.
The funding began rolling out in 2019.
Allison Sekuler, president and chief scientist at the Centre for Aging and Brain Health Innovation at Baycrest Health Sciences, says the donation will allow for an immediate expansion of programming.
She said it will now be expanding its services into underserved communities in Toronto and across the country.
That will include connecting people to their free online brain health too along with hearing tests as hearing loss is associated with an increased risk for dementia, she said.
The health-care system as it stands now, is not ready, she said.
CBC Toronto asked the Public Health Agency of Canada to respond to criticisms that they aren’t providing enough funding for dementia care. In a response, the agency pointed to investments outlined in its Canada’s dementia strategy on its website.
In a statement, Ontario’s Ministry of Health said its investment in the province’s dementia strategy will be $120 million over the next five years.
But institutions doing the work need more immediate funding, Sekuler said.
“If we don’t address these issues now, this is not sustainable,” she said. “It’s not just because of the billions of dollars Canada will be spending to address the problem directly and indirectly, but also because of the cost to human beings,” she said.
Doctors and researchers at a children’s hospital in Canada have struck a rare success after gene therapy halted the progression of rare genetic condition in a young boy.
The boy, identified as Michael, reportedly received an individualised gene therapy at The Hospital for Sick Children (SickKids) in March 2022. Michael has spastic paraplegia type 50 (SPG50).
It is an “ultra-rare” progressive neurodegenerative disorder that causes developmental delays, speech impairment, seizures, a progressive paralysis of all four limbs, and is typically fatal by adulthood.
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According to the findings of Michael’s gene therapy published in the Nature journal, approximately 80 children around the world are affected by this genetic condition.
In a bid to slow the progression of the condition, a clinical research team at SickKids administered a first single-patient gene therapy to Michael less than three years after his initial diagnosis, according to a report in the Medical Express.
Gene therapy is a way of delivering a healthy copy of a gene into the cells of a person who has a faulty gene(s). In Michael’s case, SPG50 is caused by two pathogenic variants in a gene called AP4M1.
“While these ultra-rare diseases are unique, our workflow provides a road map for gene therapies that could help many of the thousands of children in Canada with rare genetic conditions,” Dr Jim Dowling, Staff Physician in the Division of Neurology and Senior Scientist in the Genetics & Genome Biology program at SickKids, was quoted as saying by the Medical Express.
During the gene therapy, Michael was able to stand with his heels on the ground. He also experienced improvements in some aspects of his neurodevelopment.
“When we heard that Michael had been diagnosed with this terrible disease, our world fell apart. We were lost and broken as a family,” Michael’s parents, Terry and Georgia told Medical Express.
“Thankfully, we had an amazing team at SickKids and a supportive community that lifted us up and gave us the confidence to raise millions of dollars and create a therapy, not only for Michael, but for other children affected by this disease for generations to come.”
(With inputs from agencies)
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