Abstract
Ixodes scapularis ticks, which transmit Borrelia burgdorferi, the causative agent of Lyme disease (LD), are endemic to at least 6 regions of Nova Scotia, Canada. To assess the epidemiology and prevalence of LD in Nova Scotia, we analyzed data from 329 persons with LD reported in Nova Scotia during 2002-2013. Most patients reported symptoms of early localized infection with rash (89.7%), influenza-like illness (69.6%), or both; clinician-diagnosed erythema migrans was documented for 53.2%. In a separate serosurvey, of 1,855 serum samples screened for antibodies to B. burgdorferi, 2 were borderline positive (both with an indeterminate IgG on Western blot), resulting in an estimated seroprevalence of 0.14% (95% CI 0.02%-0.51%). Although LD incidence in Nova Scotia has risen sharply since 2002 and is the highest in Canada (16/100,000 population in 2013), the estimated number of residents with evidence of infection is low, and risk is localized to currently identified LD-endemic regions.
Highlights
Ixodes scapularis ticks, which transmit Borrelia burgdorferi, the causative agent of Lyme disease (LD), are endemic to at least 6 regions of Nova Scotia, Canada
Endemic Regions The first established B. burgdorferi–infected blacklegged tick population in Nova Scotia was identified in a rural region within District Health Authority (DHA) 1 in 2003
If we used Centers for Disease Control and Prevention (CDC) criteria for Western blot (WB) interpretation, the estimated seroprevalence of LD in Nova Scotia was 0%
Summary
Ixodes scapularis ticks, which transmit Borrelia burgdorferi, the causative agent of Lyme disease (LD), are endemic to at least 6 regions of Nova Scotia, Canada. In Canada, tick surveillance, coordinated and conducted by the Nova Scotia Departments of Health and Wellness and Natural Resources and the National Microbiology Laboratory (NML) of the PHAC, has identified the establishment of infected blacklegged tick populations in 6 regions in Nova Scotia, and these ticks have been found sporadically in many other locations, suggesting potential LD risk across the province. Contemporary LD risk has been difficult to quantify in Nova Scotia because of the dynamic and expanding nature of vector tick populations, occurrence of missed and/or asymptomatic infections, and changes in surveillance methods and case definitions. We describe the epidemiology of LD and the results of a 2012 provincial serosurvey for antibodies to B. burgdorferi to characterize the features and estimate the risk for LD in Nova Scotia
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