When Katie Murray* first sought medical attention for a growing constellation of concerning symptoms, doctors didn’t know what to offer her. Before suddenly falling ill, the then 50-year-old was an active, healthy, full-time nurse who loved her job and lived life to its fullest. That changed in the blink of an eye after an outdoor adventure trip canoeing and hiking near Kingston, ON.
What started as a severe flu-like episode progressed to blinding headaches, persistent fever, joint pain and profound fatigue. The circular rash that developed on Murray’s leg after the trip initially didn’t raise the alarm with healthcare providers, despite the multitude of medical consultations she pursued in a desperate search for answers to explain and reverse her declining health. Then came the neurological symptoms – brain fog, tingling and numbness, and facial paralysis.
As a nurse, Murray realized that her symptoms, from the rash to Bell’s palsy, pointed to Lyme disease, a bacterial infection that develops from the bite of a pathogen-carrying tick. Although she had never noticed a bloodsucking arachnid on her body, laboratory testing confirmed the diagnosis. Still, Murray’s journey with Lyme was far from over.
Dr. Gordon Ko, a medical rehabilitation specialist (physiatrist) with the University of Toronto, sees complex cases like Murray’s on a regular basis. When a patient’s set of symptoms meets certain criteria, including completed neurology and rheumatology testing, and a high score on a tailored risk-assessment survey, the physician questions whether they could be associated with one or more tick-borne illnesses. And as the incidence of Lyme disease steadily increases, so do concerns about contracting, detecting, and treating the infection.
According to the Public Health Agency of Canada, the number of confirmed or probable human cases of Lyme doubled in this country between 2016 (with 992 reported cases) and 2017 (with 2025) alone. Thanks to a combination of factors, including a warming climate, Lyme and other tick-borne diseases pose an escalating threat to the population.
The good news is that the majority of patients appear to recover fully when Lyme disease is caught early and treated with appropriate antibiotics. The more unsettling statistics estimate that anywhere between 10 and 40 percent of patients continue to experience debilitating symptoms even after receiving the gold standard of care following the bite of an infected tick. Others, like Murray, don’t realize that they have been exposed until their quality of life progressively deteriorates.
as the incidence of Lyme disease steadily increases, so do concerns about contracting, detecting, and treating the infection.
Without prompt intervention, the pathogen can migrate from the bite site throughout the body, causing multi-system manifestations that make the disease more severe and harder to treat. Scientists and clinicians agree that early diagnosis is ideal, however, it is complicated by the lack of a robust laboratory test that can accurately detect infection soon after the bite, or report resolution.
And for those suffering from longstanding illness, there is currently no standardized treatment protocol, thereby necessitating case-by-case, trial-and-error management of the disease. In Murray’s case, her symptoms responded to intravenous antibiotics, but returned as soon as her treatment course ended.
This critical need for improved testing and treatment for Lyme disease became apparent to Rossana Magnotta as she struggled to support her husband, Gabe, through his progressive illness. His death, from complications of Lyme disease, prompted her to establish the G. Magnotta Foundation for vector-borne diseases, with a mandate to address the gaps in biomedical knowledge that can become cracks through which sick patients fall.
In 2017, they struck a landmark partnership with the University of Guelph to establish a research facility dedicated to studying the human impact of Lyme and tick-borne illness, with the goal of improving prognosis through better diagnostic and intervention strategies. The G. Magnotta lab is now a driving force in a larger multidisciplinary movement to spur progress in this underserviced field. The result, the Canadian Lyme Consortium, unites stakeholders from the clinical, scientific, and patient communities in search of solutions to the complex ecological and biomedical challenges that threaten our wellbeing.
Today, there is already cause for optimism. Dr. Ko has followed and documented several such patients who have responded well to tailored therapies, regaining their health and quality of life. After initiating blood tests (covered by provincial plans), he refers appropriate patients for additional diagnostics and definitive treatment with Functional Medicine specialists (preferably a medical internist MD FRCPC or naturopathic physician ND with specialized training in Lyme disease).
For Murray, extended antibiotic treatment eventually addressed most of her symptoms and allowed her to return to work and play, with hobbies like rock climbing and canoeing back on her schedule. Our challenge as a research consortium is to ensure that there are more such happy endings in the near future.
* Name changed
Quick facts: Prevention is the best medicine for Lyme disease
– Know the risks and familiarize yourself with ticks.
– Wear long pants and shirts, tuck pants into socks to restrict access to skin.
– Choose light coloured clothing so ticks are visible.
– Consider technical garments with physical or chemical tick repellants.
– Check your skin and clothes for ticks often.
– Monitor pets for tick bites.
– Walk on pathways or trails.
– Avoid low-lying brush or long grass.
– Place outdoor clothing in a dryer to kill ticks.
– If you find a tick on yourself or pet, carefully remove it by grasping the head with forceps and applying even pressure and motion to withdraw it from the skin. Seek medical attention.
For more prevention tips, see: www.canlyme.ca
Know the enemy – signs and symptoms (adapted from canada.ca and www.canlyme.ca)
– Rash, sometimes shaped like a bull’s eye
– Headache (mild to severe)
– Muscle, joint, tendon and/or bone aches
– Swollen lymph nodes
– Facial paralysis
– Issues with vision, hearing
– Gastrointestinal disturbances
– Heart disorders (palpitations, abnormal heartbeat)
– Neurological disorders (dizziness, brain fog, memory loss, nerve pain, numbness or tingling in the hands or feet, mood disturbances)
– Arthritis with severe joint pain and swelling
Dr. Melanie Willis is director of the G. Magnotta Lyme Disease Research Lab at the University of Guelph and one of the presenters at the Canadian Association of Orthopaedic Medicine Conference in Markham, ON, Sept 28 to 30. The event brings together top experts to share new information and teach cutting-edge hands-on workshops relevant to the field of chronic neuromusculoskeletal pain. In addition to Lyme disease, topics include cannabis, injection therapies, nutrition, mind-body therapies and genomics. For details and to register, visit www.CAOM.ca.
Originally published in September 2018.