Lyme Disease and Other Tick-Borne Illnesses

What are tick-borne diseases?

Tick-borne diseases are transmitted to people and animals through the bite of an infected blacklegged tick (also known as a deer tick) and can potentially lead to severe illness. Tick-borne diseases include Lyme disease, Anaplasmosis, Babesiosis, and Powassan virus. Some types of tick-borne illnesses can be treated successfully with antibiotics. However, if left untreated, symptoms sometimes last from months to years and can cause serious health problems.

Blacklegged ticks live in woodlands, tall grasses and bushes, and are found throughout Ontario – including the five eastern counties. The number of infected blacklegged ticks is increasing each year.

Click here to check out the map of established risk areas for blacklegged ticks in Ontario.

Ticks are most active in the summer months, but can be found at any time of the year when the temperature is above freezing. Adult ticks are about the size of a sesame seed, while the immature nymphs can be as small as a poppy seed. When they’re full of blood, they can be as large as a grape.Not able to fly, ticks move slowly on the ground, or settle on tall grass.

Blacklegged tick card showing a nymph, an adult tick, and an engorged tick

Tick bites are usually painless, so you may not know you’ve been bitten. That's why it's important to take steps to protect yourself, and to be on the lookout for ticks and the symptoms of Lyme disease or other tick-borne diseases.

A tick bite doesn’t always result in disease. A tick has to be infected with bacteria or parasites in order to pass an infection on to you. The risk of getting a tick-borne disease from a tick bite is believed to be greater if an infected tick has been attached to you for more than 24 hours.

Symptoms of Lyme disease and other tick-borne diseases

Not all tick bites are obvious. However, if you develop any of the following symptoms following a tick bite or after spending time in an area known to have blacklegged ticks, consult your health care provider.

Lyme disease

Symptoms of Lyme disease usually occur within 3 to 30 days after a tick bite and may include:

  • Fever
  • Chills
  • Headache
  • Muscle and joint pains
  • Stiff neck
  • Spasms, numbness or tingling
  • Facial paralysis
  • Fatigue
  • Swollen glands
  • Expanding, bruise-like or unusual skin rash (however, many people never get or see a rash)

If Lyme infection is not recognized and treated, it can affect the heart, nervous system or joints. However, if it’s caught early Lyme disease can generally be treated successfully. That’s why it’s important to contact your health care provider if you believe a tick was attached for more than 24 hours or if you develop flu-like symptoms or an unusal rash in the weeks following a tick bite.

Anaplasmosis

Symptoms of anaplasmosis begin to show within 1 to 3 weeks after being bitten by an infected tick, and may include flu-like symptoms such as fever, chills, severe headache, muscle and joint pain, abdominal pain, nausea, vomiting, diarrhea and/or loss of appetite. In rare cases, if treatment is delayed or other medical conditions are present, anaplasmosis can lead to serious illness, including respiratory failure, bleeding problems, organ failure and death. Most cases of anaplasmosis can be treated successfully with antibiotics.

Babesiosis

Babesiosis is a parasitic infection transmitted by the bite of infected blacklegged ticks. Most infections are asymptomatic. However, if symptoms occur, they typically begin to show within 7 to 30 days following the bite, and can include fever, chills, sweats, headache, body aches, loss of appetite, nausea, and fatigue. Babesiosis can also cause a type of anemia called hemolytic anemia. Symptoms of hemolytic anemia include fatigue, jaundice and dark urine. Most cases of babesiosis can be successfully treated with antibiotics and/or antiparasitic drugs.

Powassan virus

Getting Powassan virus infection from tick bites is rare, but can be severe for some people. Most people who become infected with Powassan virus develop either very mild, flu-like symptoms or no symptoms at all. Symptoms can include fever, seizures, vomiting, weakness, confusion, headache, and memory loss. In some individuals, Powassan virus disease can cause serious problems such as encephalitis (inflammation of the brain) or meningitis (inflammation of the membranes that surround the brain and spinal cord).

There is currently no known treatment for Powassan virus. As with other tick-borne diseases, the best way to protect yourself is to prevent tick bites.

How to avoid tick bites when outdoors

You may be at risk of a tick bite if you live, work in, or visit a wooded area, or an area with tall grass and bushes (including city gardens and parks). You may also be at risk if you are involved in outdoor activities, such as hiking, camping, gardening and more.

You can reduce the risk of contact with – and bites from – blacklegged ticks by taking a few simple precautions.

Take the following measures to keep ticks off you and your family members when going outdoors into risk areas:

  • Wear light-coloured clothing. It makes ticks easier to spot.
  • Wear closed footwear, socks, a long-sleeved shirt and long pants. Tuck your shirt into your pants, and tuck your pants into your socks.
  • Use an insect repellent that has DEET or Icaridin on clothes and exposed skin (be sure to read and follow the manufacturer’s directions).
  • Walk in the centre of cleared paths or trails.
  • Keep children and pets from wandering off paths.
  • Avoid using trails created by animals (such as deer and moose), as ticks are often found on the grass and plants along these trails.
  • Search your clothes and body for ticks after being outdoors, especially if you were in an area where there’s tall grass or shrubs, or where ticks are known to live. Pay special attention to areas like the groin, navel, armpits, scalp and behind the ears and knees. Use a mirror to check the back of your body, or have someone else check for you. Don’t forget to tick-check your children as well!
  • Take a shower as soon as you can after being outdoors to more easily find and wash off any ticks crawling on you.
  • Ticks thrive in wet environments. Before washing outdoor clothes, put them in a dryer on high heat for at least 10 minutes to kill any ticks.

Wear light-coloured long-sleeved shirts and long pants tucked into socks to protect against ticks

Measures you can take to discourage the presence of ticks around your home:

  • Keep your grass mowed short.
  • Trim bushes and tree branches to let in sunlight as ticks avoid hot and dry locations.
  • Create a border of gravel or woodchips one metre or wider around your yard if you’re next to a wooded area, or one with tall grasses.
  • Remove leaf litter, brush and weeds at the edge of the lawn and from stone walls and wood piles.
  • Clean up areas under and around bird feeders, to reduce the attraction of small critters such as mice and voles.
  • Discourage deer from entering your yard, as ticks also feed on these animals.
  • Move children’s swing sets, playground equipment and sandboxes away from wooded areas (consider placing equipment on a woodchip or mulch foundation).

What if I find a tick?

If you find a tick on your body, remove it as soon as possible. The risk of getting Lyme disease or other tick-borne diseases increases with the length of time the tick remains attached to your body.

Since the United Counties of Stormont, Dundas & Glengarry, Prescott-Russell and Cornwall are now considered an at-risk area for Lyme disease, it is important to contact your health care provider or pharmacist if you believe a tick has been attached to you for 24 or more hours, or if you are unsure how long the tick has been attached to you, so that your health care provider or pharmacist can determine if you need treatment with antibiotic prophylaxis. Treatment with antibiotic prophylaxis could be considered when:

  • the tick has been attached for 24 or more hours AND
  • it has been less than or equal to 72 hours since the tick has been removed

If the tick was attached for less than 24 hours or if you removed a tick and more than 72 hours have passed, you should still be on the lookout for signs and symptoms of tick-borne illness for the next 30 days. If you do develop symptoms, consult your health care provider.

NOTE: The EOHU does not collect ticks removed from patients for testing or identification. To confirm if a tick is a blacklegged tick (Ixodes scapularis or I. scapularis), you can submit a photo of it for species identification to www.etick.ca.

How to remove a tick

If you spot a tick on your skin, remove it as soon as possible.

Four illustrations showing how to remove a tick: pulling a tick straight out with fine-tipped tweezers, then sliding a tick removal card's notch under the tick, pushing the card forward and upward, and lifting the tick out.

  1. Use a pair of fine-tipped tweezers or a tick removal tool to grasp the tick as close to your skin as possible. Do not use your fingers.

  2. If using tweezers: In a slow, gentle, yet firm motion, pull out without twisting, until the tick’s mouth lets go. Don’t squeeze it. Squeezing the tick can cause bacteria or parasites in the tick to be accidentally introduced into your body. If parts of the tick’s mouth break off and remain in your skin, remove them with the tweezers. If this is difficult to do, leave them alone and let the skin heal.

    If using a tick removal card: Holding the tick card flat against the skin, slide the notch under the tick. Gently push the card forward and upward with steady pressure. Allow the tick to let go and be pulled out of the skin easily.

  3. After removing the tick, place it in a secure container such as a screw-top bottle. Record the date and location of the bite (if you know), the part of your body where you were bitten, and the date you removed the tick. You may wish to take the container with the tick to your health care provider.

  4. Wash your hands and thoroughly cleanse the bite site with rubbing alcohol and/or soap and water.

  5. If you believe the tick was attached for more than 24 hours, do not delay to consult your health care provider or pharmacist.

  6. Watch for symptoms of Lyme disease or other tick-borne diseases, including flu-like symptoms and/or an unusual rash. If you have symptoms or just feel unwell in the weeks following a tick bite, seek medical attention and advise your health care provider that you have been bitten by a tick.

Watch and share this video on how to properly remove a tick.

DO NOT burn the tick or use nail polish, petroleum jelly (e.g. Vaseline) or another substance. These methods may inject tick-borne disease bacteria into the skin.

If you have pets

  • Talk with your veterinarian about appropriate tick prevention for your pet.
  • Check your pet regularly for ticks if they spend time outdoors. Ticks may attach to them and be carried indoors, putting you and your family at risk of being bitten.
  • Steps for removing a tick for your pet are the same as the steps you would follow for yourself.

Treating Lyme disease and other tick-borne diseases

See your local pharmacist for treatment if:

  • You were bit by a tick, and it may have been attached for 24 hours or more AND
  • It has been less than 72 hours since you removed the tick

See a health care provider as early as possible if:

  • You have symptoms OR
  • You feel unwell in the weeks following a bite OR
  • You feel unwell and have recently been in an area where ticks may live (even if no bite is evident)

Tell your health care provider about your tick bite or where you were. If you were bitten and saved the tick, bring it to your medical appointment.

The earlier treatment is received, the better. Most cases of Lyme disease and other tick-borne diseases can be treated successfully with a few weeks of antibiotics.

For more information about tick-borne diseases, call the Eastern Ontario Health Unit at 613-933-1375 or 1-800-267-7120.

Additional resources