A Quebec-based researcher is asking residents of the Southeast to share their thoughts on ticks and Lyme disease.
Natasha Bowser, a PhD student in veterinary science at the University of Montreal, is conducting virtual focus groups in Lyme hotspots across Canada to determine whether the increasing prevalence of the disease is affecting enjoyment of the outdoors.
"We’re asking people to tell us how they feel about living around ticks, and whether they do anything differently," Bowser explained in a phone interview.
After hearing from residents of British Columbia, Ontario, Quebec, and Nova Scotia, Bowser is now turning her attention to Manitoba, especially southern areas where Lyme disease is endemic.
Later this month, Bowser will conduct 90-minute Zoom focus groups in Manitoba. Participants must be over the age of 18, don’t need to have contracted Lyme disease, and will be compensated for their time.
Questions will cover what people already know about Lyme disease, where they go to find more information on it, and how and why they protect themselves, their pets, and their property.
"We don’t have any specific hypotheses about what we’re expecting people to say. It’s a very open question," Bowser said.
She’s especially interested in hearing from those who work or play outdoors, parents of school-aged children, and pet owners.
Bowser said she wants to learn whether worries about ticks and tick-borne illnesses are sapping Manitobans’ enjoyment of nature. Some participants in other provinces have already told her they’re spending less time outside.
Bowser said a lot of Lyme research has focused on Lyme symptoms and treatments, while little is known about voluntary lifestyle changes prompted by the threat of the disease.
"Are they worried, do they have concerns, are there impacts on their work opportunities, what they do and don’t do in terms of leisure with their family outside, that kind of thing," Bowser said. "We’re asking that really because it hasn’t been documented before."
The University of Montreal is funding Bowser’s research, which is part of a larger program coordinated and funded by the Canadian Lyme Disease Research Network, a coalition of "researchers, patients, community members, practitioners, and educators."
Bowser’s findings will eventually be published in a scientific journal later this year. Participants will also be sent a results summary.
Ultimately, Bowser wants to develop a website or smartphone app to inform Canadians about how to protect themselves against ticks.
Lyme disease is the most common tick-borne illness in Canada. It is spread to humans through the painless bite of an infected nymph or adult deer tick, also known as a blacklegged tick.
Nationally, Lyme cases increased more than 14-fold between 2009 and 2017, according to Health Canada. As recently as 2016, nearly 90 percent of cases were concentrated in Ontario, Quebec, and Nova Scotia, but that is changing. Health Canada has identified more than 40 Lyme disease risk area in Manitoba, including 12 in the Southeast.
Bowser said Lyme disease in endemic in several parts of southern Manitoba. However, rates of infection here remain low compared to Nova Scotia and Ontario, where the response to her focus groups has been "overwhelming."
The Manitoba government’s most recent annual report on tick-borne disease, published in 2020 using 2018 data, found 2018 was "the most active year to date in terms of Lyme disease in Manitoba."
"The public health burden posed by tick-borne diseases (TBDs) in Manitoba, as seen
elsewhere in Canada and the United States, continues to increase," the report stated.
Bowser said southeastern Manitoba has a higher incidence of Lyme disease than other parts of the province. Between 2013 and 2018, confirmed cases among residents of Southern Health increased to 10.77 per 100,000 people.
Localized further, the Rural East health district, which stretches from Gardenton to the Ontario border, reported 101 cases per 100,000 people, higher even than the Whiteshell, which reported 65 cases per 100,000 people.
According to the province, both of those districts have some of the oldest established populations of blacklegged ticks, which arrived sometime between the early 1990s—when Canada’s lone Lyme hotspot was the Lake Erie coastline—and 2014, when 22 endemic areas were found across Canada.
"The key driver of this rapid range expansion…is climate change," Manitoba’s report noted.
Warming temperatures have expanded blacklegged tick habitat and increase seasonal activities that bring humans into contact with ticks. Migratory birds also carry infected ticks to new areas.
Not only are blacklegged ticks found in more places; the percentage of blacklegged ticks carrying Lyme disease has also increased. Those are the areas Bowser is studying.
After working as a veterinarian for several years, she developed an interest in zoonotic diseases, which jump from animals to humans. That led her to an interest in Lyme disease, which in recent years has been surrounded by confusion.
Bowser said that’s because not everyone who is bitten by an infected tick develops the telltale bull’s eye rash. Others never find a tick at all and assume they have the flu.
"The first symptoms you get can be very non-specific."
According to the Canadian Lyme Disease Research Network, in addition to clinical challenges, there are also conflicting views on the natural history of the disease, the effectiveness of diagnostic tests on current strains, and how best to prevent and treat the disease with antibiotics.
To register for one of Bowser’s focus group or request more information, email firstname.lastname@example.org by Jan. 15.