Patient, researcher say a rapid tick test needed in N.S. Lyme fight

Margo Beveridge checks herself carefully for ticks every day after going outdoors. The Halifax woman has been bitten twice by ticks — once on the back and once on her eyelid.

"It's kind of a disgusting experience," she said of finding the embedded ticks. 

Both times her doctor prescribed antibiotics out of a concern she would catch Lyme disease and both times she bagged the tick and sent it for identification.

Then Beveridge began to wonder how she could get more information about what had bitten her. 

"Someone said to me, 'Why don't they test the tick?' And I thought that's a good question. Why don't they test the tick for disease?" 

It is possible to find out what diseases a tick carries, but chief medical officer of health Dr. Robert Strang says those tests do not return results fast enough to be useful to doctors and patients making medical decisions.

The province monitors ticks through other methods. Each year biologists go to the woods and capture ticks to study them for spread and diseases.

Prior to 2016, the province also accepted ticks submitted by the public and identified their species to track their spread. Only blacklegged ticks can transmit Lyme disease. But since 2016, the province has modified its strategy to fight ticks. 

"We now have established tick populations in Nova Scotia," said Strang. "We know that."

He noted other provinces are still treating ticks and Lyme disease in the "emerging" stage. 

"They may still be encouraging people to submit ticks to help them with their surveillance," he said. "We're beyond that in Nova Scotia. So that's why we stopped."

The provincial Department of Health says it does not need the public to submit more information about the spread of ticks because the bugs are established everywhere in mainland Nova Scotia. It is now analyzing the ticks for Lyme disease, anaplasmosis, babesiosis and Powassan virus.

Last year, the Health Department's testing showed between 22 and 59 per cent of the captured ticks had the bacteria that causes Lyme disease. On average, about 41 per cent of the ticks had Lyme. 

Strang says another reason the province does not test ticks for disease is because it doesn't give results fast enough to be helpful to a doctor trying to treat a possible Lyme infection. 

"We need clinical decisions far faster than you could ever get a turnaround time on identifying a tick," he said.

Canada's National Microbiology Laboratory can generally provide results in two and six weeks. Clinical decisions about Lyme must be made in a matter of days.

But patients like Beveridge often want to get their ticks analyzed anyway. 

Researcher Vett Lloyd of the Mount Allison University Lyme Research Network tests ticks submitted by New Brunswick and P.E.I. residents. She determines whether each tick is carrying the bacteria that causes Lyme disease and sends back a result.

Lloyd also receives between 300 and 500 ticks removed from people in Nova Scotia each year. She tests those ticks for Lyme at the request of the patients who submit them, because she recognizes Nova Scotians have no in-province options.

"There's still very much a need for testing a tick that shows up on someone," she said. "You find a tick on yourself, you find a tick on your child, you want to know whether that tick was infected."

She agrees with recommendations from the Public Health Agency of Canada and provincial health departments across the country that medical treatment in humans should never be based only on what was inside the tick.

However, judging by the demand from Nova Scotians who are sending ticks to her lab, she thinks a dedicated tick-testing service could be of use in this province. 

"Making it rapid is really just a matter of how many ticks that are tested," she said. "It takes a long time to test it in the one lab that does all of Canada's tick testing because Canada's a big place with a lot of ticks in it. A Nova Scotia tick-testing facility could deal with Nova Scotian ticks. That would be one way of making it faster. The technology itself is routine in research labs and hospitals.

"I think when you have that many people having their health impacted, being impacted by ticks, that is a signal that really proactive moves to help people determine the risk of getting a tick-borne disease is a really good idea." 

Strang said he's not aware of any facility that has moved to such rapid testing. 

"Maybe someday we'll have that kind of point-of-care testing," he said. "We also have to remember that lots of people come in without a tick. They may be in a tick-infected area and may have had a tick on them that is no longer there."

Beveridge no longer has the ticks that bit her, so she cannot submit them to a lab for testing.

She completed the courses of antibiotics and her health is fine. However, she says she and other patients may still have many questions that would be eased with more information.

"I would like to know if the ticks that I had, if they actually were carrying Lyme disease," she said. "Then I would be more vigilant about myself if I noticed any symptoms that might indicate that perhaps I had been infected.

"I might want to talk to my doctor about whether I should have a second, follow-up Lyme disease test done. I'd just like to be better informed."