Make sure you avoid these serious illnesses after enjoying summer activities outdoors

Three years ago, Jan Cmela was an adventure-race organizer, cyclist and hiker who was training to traverse obstacle courses.

Today, the 50-year-old Springfield resident suffers with concentration issues and headaches and can spend days working from her bed, owing to the debilitating effects of Lyme disease, a once-obscure tick-borne illness that is now the most common serious environmental disease you can contract in Manitoba.

Since 2009, there have been 114 confirmed or probable cases of Lyme in the province, according to Manitoba Health. In that time frame, Lyme disease and blastomycosis — a fungal disease contracted from Canadian Shield soil — each afflicted more Manitobans than the far more well-known West Nile virus, in terms of reported cases.

Even though the relative threat of contracting Lyme is low, sufferers and health authorities alike urge more Manitobans — especially people who spend a lot of time outdoors — to become more familiar with the symptoms of emerging infectious diseases so they can seek treatment early and avoid chronic illness.

"You might not get symptoms right away. I didn't see a tick," said Cmela, who developed most of the symptoms of severe Lyme disease — numbness, tingling, exhaustion and cognitive problems — within a 10-minute span in 2013.

"The testing is not very accurate. The doctors may not recognize this might be the case, and that's why a lot of us are getting sick," she said.

Cmela wound up travelling to the U.S. to receive a diagnosis for Lyme disease, which often, but not always, presents itself first as an expanding, bullseye-shaped red rash around a bite from a black-legged or deer tick.

As recently as a decade ago, these small ticks — about 40 per cent the size of the far more common dog or wood tick — were all but unknown in Manitoba and some doctors dismissed the idea Lyme disease was a local threat.

Since then, black-legged ticks have migrated north and west along Manitoba river valleys and have established populations in dozens of locations, including Birds Hill Park, sections of the Trans-Canada Trail and cities such as Winnipeg and Steinbach.

Only established populations have ticks infected with the bacterium Borellia bergdorfuri, which causes Lyme disease, said Dr. Richard Rusk, a medical officer of health with Manitoba Public Health.

"Five years ago, if you would ask me, I would say, 'Oh, your threat of getting Lyme disease is next to nothing.' The chance of getting that disease is still low, but I'm afraid it's there," Rusk said.

"We know we don't have the greatest climate for these ticks to flourish compared to areas further south. Come November, they basically shut down."

Lyme disease, which initially presents flu-like symptoms, is worrisome to medical authorities because it can be difficult to diagnose and prevent.

Compared to wood or dog ticks, which you tend to feel as they crawl around on your body, you may not feel a smaller deer or black-legged tick moving about. You also may not see deer ticks as easily when you conduct a visual "tick check" after spending time outdoors.

The good news is, not all deer ticks carry Borellia or two other disease-causing bacteria known to be present in Manitoba deer-tick populations. The province is aware of this as a result of a surveillance program that involves dragging the brush for ticks and testing them for the presence of pathogens.

Even better news, a deer tick has to attach itself to you and feed for 24 hours in order to make you sick. Unfortunately, people who contract Lyme disease may not seek medical attention early on, when treatment with antibiotics is effective.

"You definitely can get very, very sick, but we have some really good experts on this now," Rusk said, adding an effort is underway to educate more doctors about the symptoms.

Cmela said she's happy that's happening, but fears there is no effective treatment for chronic sufferers such as herself.

"I don't want to alarm people, but if you're not cured, they don't know what to do with you," she said. "I went from no symptoms to full-blown neurological symptoms and they're still here today."

Diagnosis is also a problem with blastomycosis, which may be misdiagnosed as pneumonia or flu. It too was all but unknown in Manitoba before cases started emerging in cottage country. Since 2009, 72 cases of blasto have been reported in the province.

Diagnosis of West Nile virus can also be tricky, even with the tremendous attention brought to the mosquito-borne illness over the past decade. Since 2009, 49 cases have been reported in the province, of which 39 occurred in 2012 alone.

Cases of two other environmental infectious diseases that could be contracted in Manitoba — hantavirus and rabies — are extremely rare. They're still worth noting because they're deadly: the rodent-borne hantavirus (one Manitoba case in 2012) kills about a third of its patients, while rabies (no provincial cases in recent years) kills everyone who isn't treated within the first 24 hours.

 

Rusk said Manitobans ought to be much more concerned with contracting food-borne and water-borne illnesses each summer, noting more than 4,500 cases of everything from salmonella and giardia to typhoid and Hepatitis A have been reported since 2009.

"If you're talking summer diseases, food-borne illness is very seldom highlighted," he said. "You have a far greater risk of getting something from your burger than you have from a tick."

At the same time, he said, Manitobans should familiarize themselves with black-legged ticks, especially if they spend time outdoors.

bartley.kives@freepress.mb.ca