Study gathering data on early signs of childhood Lyme disease

A new Canadian Paediatric Surveillance Program study is collecting Lyme disease data to help paediatricians recognize and treat the disease more quickly, and to help establish preventive measures.

“If you recognize Lyme disease early and treat it, you won’t have those long-term consequences for the most part,” said Dr. Joanne Langley, co-principal investigator of the study and Professor of Pediatrics and Community Health and Epidemiology at Dalhousie University. “The problem is that some people with Lyme present when they already have the long-term complications.”

Lyme disease in children can present in the weeks following a bite from a tick containing the spirochete Borrelia burgdorferi with a characteristic rash called erythema migrans.

It may also present months to years later as heart, joint, skin, or nervous system illness.

“One would hope that if we have better recognition of the early presentation of Lyme, we have fewer people who present with the long-term complications,” said Dr. Langley.

Through the study, Dr. Langley hopes to determine the number of children and youth with the disease in Canada, as well as their age, gender, and province/ territory.

“There’s epidemiological evidence to suggest that the frequency of Lyme disease will increase with environmental change,” she said. “It’s important that we can describe what’s going on now, so that we can prepare for the future.”

Current data suggest that Lyme disease risk is highest in southern Ontario, Quebec, Nova Scotia, New Brunswick, Manitoba and southern British Columbia, but risk areas are spreading. Projections suggest that up to 80% of Canadians will be living in areas endemic to ticks carrying Lyme disease by around the year 2020.

“We hope to improve our understanding of where Lyme disease is likely to appear in Canada and therefore, what resources are needed to prevent it and treat it early,” said Dr. Langley.

She said accurate data will provide information needed to develop public health campaigns in at-risk areas. For physicians, it may improve early recognition, particularly for acute cases.

“We hope that the study will increase awareness of how we diagnose Lyme disease. In acute Lyme disease, you don’t have a lab test in front of you. You just have a clinical presentation, which is a particular kind of rash, initially. We’re hoping that one benefit of surveillance is that people will be on the lookout for those kinds of clinical findings.”

This study runs from July 2014 to June 2017. Visit www.cpsp.cps.ca for details.

For more information on paediatric Lyme disease, see a recent CPS practice point, available at www.cps.ca/en/documents/position/lyme-disease-children

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