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. 2017 Oct 5;43(10):194-199.
doi: 10.14745/ccdr.v43i10a01.

Surveillance for Lyme disease in Canada: 2009-2015

S Gasmi  1 , N H Ogden  2 , L R Lindsay  3 , S Burns  4 , S Fleming  5 , J Badcock  6 , S Hanan  6 , C Gaulin  7 , M A Leblanc  7 , C Russell  8 , M Nelder  8 , L Hobbs  8 , S Graham-Derham  9 , L Lachance  10 , A N Scott  11   12 , E Galanis  13 , J K Koffi  1
Affiliations

Surveillance for Lyme disease in Canada: 2009-2015

S Gasmi et al. Can Commun Dis Rep. .

Abstract

Objective: To summarize seven years of surveillance data for Lyme disease cases reported in Canada from 2009 to 2015.

Methods: We describe the incidence over time, seasonal and geographic distribution, demographic and clinical characteristics of reported Lyme disease cases. Logistic regression was used to explore differences between age groups, sex and year to better understand potential demographic risk factors for the occurrence of Lyme disease.

Results: The number of reported Lyme disease cases increased more than six-fold, from 144 in 2009 to 917 in 2015, mainly due to an increase in infections acquired in Canada. Most locally acquired cases were reported between May and November. An increase in incidence of Lyme disease was observed in provinces from Manitoba eastwards. This is consistent with our knowledge of range expansion of the tick vectors in this region. In the western provinces the incidence has remained low and stable. All cases reported by Alberta, Saskatchewan and Newfoundland and Labrador were acquired outside of the province, either elsewhere in Canada or abroad. There was a bimodal distribution for Lyme disease by age with peaks at 5-9 and 45-74 years of age. The most common presenting symptom was a single erythema migrans rash (74.2%) and arthritis (35.7%). Variations in the frequency of reported clinical manifestations were observed among age groups and years of study.

Conclusion: Lyme disease incidence continues to increase in Canada as does the geographic range of ticks that carry the Lyme disease bacteria. Ongoing surveillance, preventive strategies as well as early disease recognition and treatment will continue to minimize the impact of Lyme disease in Canada.

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Conflict of interest statement

Conflict of interest: None.

Figures

Figure 1
Figure 1. Month of Lyme disease illness onset for locally-acquired infection: Canada, 2009–2015 (n=2,010)
Figure 2
Figure 2. Reported locations of Lyme disease acquisition, Canada, 2009–2015
Legend: The size of each circle represents the number of cases acquired in a given municipality. The centre of each circle is the centroid of the probable municipality of acquisition. The data on location of acquisition are not available for cases reported in British Columbia, Saskatchewan and Quebec. Furthermore, cases reported in Alberta and Newfoundland and Labrador are travel-related cases only. Hatched areas indicate Lyme disease risk areas. These are locations where field surveillance suggests that populations of the Lyme disease vector Ixodes scapularis have begun to become established (1)
Figure 3
Figure 3. Incidence of Lyme disease by age group and sex, Canada 2009–2015 (n=3,004)
Figure 4
Figure 4. Percentage of clinical manifestations for Lyme disease infections acquired in Canada, 2009–2015 (n=1,657)
Figure 5
Figure 5. Percentage of reported Lyme disease casesI by clinical manifestation and age group, Canada, 2009–2015 (n=1,657)
Abbreviation: %, percentage I Reported in the Lyme Disease Enhanced Surveillance System
See this image and copyright information in PMC

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