Jordan Heath-Rawlings: This might not be the first thing you want to hear on Monday after you’ve hopefully spent a lovely weekend enjoying the summer outdoors, but I need you to stop right now and do a tick check.
News Clip: They’re not just crawling around back woods anymore. Black legged ticks. They’re now in tall grasses and wooded areas in big cities.
News Clip 2: And over the past five years we’ve seen an increased number, but also they are covering a larger area of Southern Ontario.
News Clip 3: Now, Lyme disease has also moved into Southern Ontario, PEI, and BC.
News Clip 4: This is something we want every doctor to understand that the risk for Lyme disease is increasing in Canada.
Jordan Heath-Rawlings: Ticks have lived in many parts of Canada for years, but recently they are spreading further and further from their prior habitats. And yes, climate change is a big part of the reason for this. But that’s true for almost everything that’s bad right now, so we won’t dwell on that. What we’re going to do today is arm you with the info that you need to avoid ticks, if you’d like to start with that, to identify them if you see them, to safely remove them, if you find one on you or anyone else, and what needs to happen immediately after you do that. Because while most people understand that ticks carry Lyme disease, not as many people know that not all ticks carry the disease, that Lyme disease is treatable if you catch it early, and that there is currently a lot of work being done on how to rapidly diagnose ticks for the disease after they’ve been caught. So that’s what we’ll do today.
But first, I really wasn’t kidding. I need you to check. Look behind your knees.
Jordan Heath-Rawlings: I’m Jordan Heath-Rawlings. This is The Big Story. Justin Wood is the founder of Geneticks, Canada’s first private tick testing lab. He is also himself a survivor of Lyme disease, a passionate advocate for Lyme disease awareness. And he’s committed to minimizing the spread of Lyme disease and other tickborne diseases in Canada. Hello, Justin.
Justin Wood: Hi, Jordan.
Jordan Heath-Rawlings: This is kind of a public service episode that we wanted to do given the time of year. So maybe we could just start with the basics. What are ticks and what do they look like?
Justin Wood: Most people think of ticks and they think of insects, but ticks are actually not insects. They’re arachnids. So they’re more closely related to spiders or mites or even scorpions than your kind of standard insect. They’re very small. The adult ticks are usually between, let’s say, two and five millimeters when they’re unfed and the sort of other life stages, the younger ticks that we would call nymph stage, and the larval stage are even smaller than that. So nymph ticks generally start out about one millimeter in length and larvae even smaller than that. So you can imagine the they’re pretty difficult to find. They’ve got eight legs, so they kind of look a bit like a spider like that. And they’ve got these hard sort of shells on their back that it’s called a scutum or a shield. That’s kind of what protects them from the environment.
Jordan Heath-Rawlings: That’s really interesting. Before we get to the rest of it, though, I do have to ask you, how did you get into founding genetics and working on tick borne illnesses in general? Was it when you contracted Lyne disease?
Justin Wood: Yeah. I got into this field of work because of my experience with Lyme disease. Before I got sick, I was doing my Masters out of the University of Calgary, and I was working in a field of genetics called functional genomics. I started to get sick. I didn’t really know what was going on. I managed to finish by Masters. I kind of thought I was getting better, and I applied for a PhD, and I was accepted to a PhD in neuroscience, and I was pretty excited about that. And I got really sick at that time, and I kind of had to withdraw from that and pull out. And I didn’t really know what was going on. And eventually, after must have been at least another year, maybe two, I finally got diagnosed with Lyme disease, and I had this really difficult, long journey back to recovery.
And through that, I met a number of people in the Lyme disease world. And I became really aware of some of the shortcomings that people were facing when they were trying to get diagnosed with Lyme disease, when they were trying to protect themselves from ticks. And as I got better, I thought, okay, I really want to jump back into something in science, but something that also helps with this huge growing problem of Lyme disease. And tick testing seemed to me like an area that was not being handled particularly well in the fact that if you got bit by a tick and you wanted to know what it was carrying and what you’ve been exposed to, you didn’t really have a great opportunity to do that quickly and easily. So I thought, okay, this is something that I can do, and I just kind of jumped in from there.
Jordan Heath-Rawlings: That’s fascinating. Is your story, and I don’t mean here the Genetick side of it, but it is your story kind of typical in terms of people trying to get diagnosed, not really knowing what it might be, why they’re sick, or have we gotten better at that?
Justin Wood: Yeah. Unfortunately, my story is more typical than I would like it to be. I think we’ve gotten a little bit better in the last, let’s say, five years, 10 years since I’ve been sick and diagnosed. But we’re still not at a point where I would say it’s good. People are more aware about Lyme disease now than they were before. And I think physicians are looking for Lyme disease more now than they would have been 5, 10 years ago. But I don’t think we’re at a place where everybody that gets bit by a tick or everybody that contracts Lyme disease is going to know about it. They’re not going to know about it early. They might fight for a diagnosis. They might not even know to look for a diagnosis of Lyme disease. So I think we’ve still got quite a ways to go there.
Jordan Heath-Rawlings: And so the ticks we’re talking about today, are all ticks potential carriers of Lyme disease? Only certain ones> You mentioned there are other tick borne illnesses. So I am guessing that some of them have Lyme disease and some of them don’t. But what are we looking at specifically in Canada?
Justin Wood: In Canada, the main culprits for carrying Lyme disease are the black legged tick and the Western black legged tick. We don’t tend to see Lyme disease so much in other species, though I have heard reports of it being there. I just can’t really personally confirm that. Other ticks, though, do carry other tickborne diseases. You’re right. So some of the other major ticks that we might encounter in Canada, besides the black legged tick and the Western black legged tick, are the American dog tick and the Rocky Mountain wood tick, and a couple of other species of tick that are pretty closely related to the black legged tick, but a little bit different. And I think for some of those, the research is still sort of out, the jury is still out on if they carry Lyme disease or if they carry Lyme disease-like illnesses, if those are transmissible from those ticks to humans, what the rate of transmission is like from them.
I think we still need a little bit more research to absolutely confirm that. But for the most part, the black legged tick and the Western black legged tick are the major culprits in Canada. They’re the ones that you got to be sort of the most vigilant for. And sort of in our experience, we tend to see depending on the region, anywhere between sort of 10 and 50% of black legged ticks, especially here in Ontario that are carrying the pathogen that causes Lyme disease.
Jordan Heath-Rawlings: So you said depending on the region, where in Canada can ticks with Lyme disease be found? And are they spreading?
Justin Wood: Yeah, they absolutely are spreading, I’ll say that first. The major regions where we find the black legged tick is sort of anywhere in Eastern Canada. So from Nova Scotia, moving West across Canada, through the rest of the Maritimes, Quebec, Ontario, into Manitoba, that’s sort of the main range of the black legged tick. That’s the major carrier of Lyme disease in Eastern Canada. And that range is expanding every year. So those ticks are moving further North in these provinces, and they’re also moving further West across into the Prairies. We don’t see a lot of those ticks yet in Saskatchewan and Alberta, we tend to find what are called adventitious ticks there. And those are ticks that have maybe been carried there by a migratory bird. They’ve been dropped off. And then on the West Coast, we have this other species of tick called the Western black legged tick, which is closely related. We find a lot of those out on Vancouver Island and then through sort of BC and the interior of BC. And those also carry Ly disease. And again, those ranges are all also extending.
Jordan Heath-Rawlings: As they expand, are we seeing more cases of Lyme disease in humans? Can you kind of give me a general sense? I know from reading some of your work that we’re on an upward trajectory here, but maybe try to give us a sense of how worrisome that is and how quickly it’s happening.
Justin Wood: Yeah. I mean, I don’t like to be particularly alarmist, but I think this is something we do sort of need to ring the alarm bell about, because people do need to know that they are at an increased risk every year that goes by. So to kind of put that into perspective, what’s happening is as we have changes in the climate, we’re having much, sort of shorter and less intense winters. And that’s leaving us with the situation. We have longer Springs, longer falls, a longer summer. So these are all the periods where ticks are active. And if ticks have more time to be active, they have more time to find hosts to feed, to reproduce. And that means that the populations of ticks in Canada are bolstering every year. And what you can add to that is this issue that ticks are generally transported by migratory animals and particularly migratory birds. So it’s estimated that every spring, somewhere between 50 and 175,000,000 new ticks are transported on the back of migratory birds-
Jordan Heath-Rawlings: Yikes.
Justin Wood: Up from the States into Canada. They’re dropped off there. And those bolster all those already reproducing populations of ticks established in Canada. As we have more ticks, they start to spread further and further North. The climate is becoming better for them. They can survive the higher and higher latitudes. And unfortunately, as these tick populations spread, so do their reservoir species. So these are usually small mammals that carry the pathogens that cause these diseases. And they’re the ones that give it to the ticks. And then the ticks can then give it to humans. And we’re also seeing those populations spread further North and further West. And that means we have more ticks that are carrying Lyme disease than we would have the year before that. So if you kind of put that all together, you have this issue of more ticks, more ticks carrying diseases, new diseases as well, and sort of spreading across Canada.
Jordan Heath-Rawlings: So tell me about how you go about tracking the spread of ticks carrying various diseases across the country.
Justin Wood: Yeah. So we’re a tick testing laboratory. So people will find ticks on themselves or their loved ones or animals, and they’ll submit those to us, and they’ll generally request some sort of testing on it. So they may want testing just for Lyme disease. They may want testing for Lyme disease and other tick borne pathogens. And so while we’re kind of offering the service, we’re also passively collecting data. So whenever somebody submits a tick, we ask them a number of questions about the tick, where it was found, what they were doing, where they were, when they encounter them, that sort of thing. And then the ticks arrive and we identify them. We say, okay, this was a black legged tick. This was an American dog tick, that sort of thing. And then we do the testing and we get the results. At the end of this process, the main goal is to send that information back to people and say, okay, you were bit by a tick. It was the black legged tick. It was carrying Lyme disease. You may be at risk of contracting Lyme disease.
But the sort of side product of that which is very useful as well as now, we have this great database of information where we can look at and we can say, okay, this tick was submitted from this area in Ontario. It was this species of tick. This is what it was carrying in terms of pathogens. And as we get somewhere in the thousands of ticks submitted every year, it gives us all sorts of really great data points across Canada. And we can then take those and we can remove the identifying information from people. We can plot them on a map. And we can present that to the public and say, in 2020, here are all the ticks that were submitted to us. We can generate all sorts of really useful information which we can then turn into a sort of easily digestible resource for the public to look at and kind of say, okay, this is where ticks are. This is where we’re seeing new pathogens emerge. And every year, as we continue to update that information, you’ll be able to kind of look and say, okay, in 2020, this was the range of ticks and pathogens. What about 2021, and 2022? 2025 and get this really great sort of real time update of what’s happening with ticks in Canada.
Jordan Heath-Rawlings: So we’re seeing and partly thanks to your data, more ticks in more places, perhaps carrying more pathogens. Is the government doing anything to tackle this problem? And if so, what?
Justin Wood: Yeah. I think the government is tackling this problem. They have a program called eTick, which is if you get bit by a tick, you can take a picture of the tick and you can submit it to them and they’ll tell you, okay, from your picture, it looks like this is this species of tick. And in the same sense, they’re tracking the spread of ticks that way as well. What I think is sort of missing from that is that they don’t have any information about what those ticks are actually carrying. It becomes sort of a risk assessment in the terms of, okay, so I was bit by a tick. I took a picture of it. They say, okay, that was a black legged tick. And then they might say there’s about a 20% chance that that tick is carrying Lyme disease, but they’re not actually tracking which ticks actually have those pathogens in them or not through that program. They have another program where they go out and they do what’s called active sampling. So they send a team into the field. They drag for ticks sort of randomized locations, take them back to their lab, test them, and then they get sort of that information that way. So between those two, they are tracking this read of ticks and tickborne diseases. But we sort of like the idea of this very real time, what people are interacting with, what are people actually encountering, and what are those ticks actually carrying?
Jordan Heath-Rawlings: But are they doing anything too slow or stop the spread? We did an episode a little bit earlier on Gypsy Moths and using sprays to try to control the population or trapping them or whatever. Is any of that even possible for ticks?
Justin Wood: Yeah. Ticks are tricky that way. There’s not a ton that we can kind of do in that sense that I’m aware of, at least. I do know there are sprays out there that people might pay a company to come and spray their lot with chemicals that repel ticks. And that helps keep ticks off your particular property. But it’s not really something that we can go and spray across the entire environment. Ticks are very hardy. They’re difficult to kill, they’re resistant to a lot of things. I think really the best thing that we can do right now is be aware of them and sort of know how to coexist as safely as we can with them.
Jordan Heath-Rawlings: So let’s talk about how we can coexist and be aware, then. Where should people be on the lookout for ticks? I think my assumption and I think maybe the thing I’ve always been told is long grass bushes. I always think about it when I’m wandering around in the deep rough on the golf course. That kind of stuff. Is that. Is that true? Is that a stereotype?
Justin Wood: No, that’s absolutely correct. What I tend to tell people is that the ticks that we’re most concerned about for Lyme disease, the black legged tick, the Western black legged tick, is they tend to like cool, damp areas. They also like long grasses and sort of knee height sort of shrubbery. The way that ticks find their host is that they’ll climb up on to, let’s say, a tall piece of grass or a little bit of vegetation, let’s say on the side of a trail or something like that. And they’ll stand there on the edge of that, and they’ll kind of hold on to the piece of grass with their back four legs, and then they’ll waive their front two legs in the air. And at the end of those legs are these really sensitive organs called Haller’s organs. And those are how ticks sort of interact with and sense their environment. So they can pick up all sorts of stimuli that way, in particular things that tell them if potential prey is coming their way. So they might be able to detect really small changes of carbon dioxide in the environment. And they say, okay, to me, that means there’s a mammal coming my way. And they’ll sort of orient themselves on the end of this grass, then wave their front two arms in the air, which are also quite sticky. They wait for that to come by, and then they’ll grab onto it. So the best way to avoid ticks is to avoid the environments where we know ticks like to be and where they’ll be sort of doing that behaviour is called questing, where they’ll be doing that questing behaviour, waiting for somebody to kind of pass by that they can grab onto. So for me, that’s often, like you said, the roughs of golf courses are a great idea. The edges of trails where they sort of that maybe knee height vegetation. Leaf litter in the fall is another big one. Ticks love to live in the leaf litter. It protects them. It’s cool and damp. Sort of forested areas, wood piles, all sorts of places like that.
Jordan Heath-Rawlings: And what do we do if we want to protect ourselves? Long pants, I’m sure. But also, does bug spray work on them? Is there anything else people could use?
Justin Wood: Yeah. I think there’s a couple of things people can do. I think the most important is to do frequent tick checks. You have to remember how small ticks are, and you have to remember what you’re looking for, especially in the summer months when the tick nymphs are out. So sort of what we’re in now in June, July, August, the ticks that we tend to be looking for are about the size of a poppy seed. So it’s really important that people are really vigilant when they are out in the outdoors or they’re coming back from the outdoors that they check everywhere on their bodies for these tiny, tiny ticks. Behind the knees, the groin area, armpits, behind the ears, scalp, really vascular areas they tend to be attracted to. So to check those areas really carefully and try and find these ticks, and if they’re found to make sure that they get removed properly.
Jordan Heath-Rawlings: So how do you do that? Remove a tick properly?
Justin Wood: Yeah. There’s a lot of misinformation about that as well. I think the best way to do it is a very fine tipped pair of tweezers, and you want to take those and you want to try and grasp the tick as close to the skin as you possibly can. You don’t want to squeeze the body of the tick. You just want to try and grab the head of it. So you have to make sure that you’re putting those tweezers in flat against the skin as absolutely close as you can. And then you want to gently but firmly grasp the tick, and you want to pull directly up and out of the skin. So you don’t want to pull on an angle. You don’t kind of want to joss or anything because you don’t want to accidentally break off any of those mouth parts or anything that the tick is feeding through. You want to make sure you pull the whole tick up and out. So when you grasp it, you start to pull up. You’ll feel some resistance because the ticks sort of anchor themselves into the skin. And then it almost feels like a little bit of a pop as you pull it out of your skin.
Jordan Heath-Rawlings: What do you do with it afterwards? And what do you do yourself afterwards?
Justin Wood: Yeah. So the best thing to do with the tick after, in my opinion, is to store the tick, and then you can send it for testing. Even if you don’t want to send it for testing right away, you can store it in your freezer for up to a couple of years. And if you start to get sick somewhere down the line, you wonder, could this have been caused by that tick? Then you can still send it away for testing. You should, after you’ve removed the tick, you should make sure that you wash the area with an alcohol rub or something like that if you have it, and then soap and water. And I think a really good thing to do is also to consult a knowledgeable physician and say I have been bit by a tick. If you can get it identified, that’s great. You can say it’s a black legged tick. There’s about an average in Ontario a 20% chance that this tick would carry Lyme disease. And then you can make sort of a judgment call with your physician of whether you want to treat prophylactically for Lyme disease. If you want to test the tick and determine if it does carry the bacteria that causes Lyme disease before you treat, or if you just kind of want to wait. I think that’s up to the person and the physician, but my experience says that the best thing to do in that case is to err on the side of caution and either test the tick or decide to treat prophylactically because the consequences of Lyme disease going untreated is much more severe generally than taking a course of antibiotics or something like that.
Jordan Heath-Rawlings: That was going to be my last question to complete the circle, I guess.
Justin Wood: Yeah.
Jordan Heath-Rawlings: What happens when you contract Lyme disease? Can you treat it early enough that it’s not a problem? Are you in it for the long haul automatically, like what goes down as soon as you’re diagnosed or suspected to be diagnosed anyway?
Justin Wood: Yeah. So if it’s caught early, it can generally be treated quite easily with a shorter course of antibiotics. So I think a lot of the Public Health Agency of Canada lists 14 days to 21 days of generally it’s doxycycline or amoxicillin or cephalosporin-based antibiotic, and that’s generally in the early stages. Let’s say, within four weeks of a tick bite, enough to sort of knock out that infection. The problem comes when you get into something called late disseminated stage Lyme disease. So this is when you’ve been bit by a tick and that tick transmits the bacteria that causes Lyme disease to you, and then that bacteria spreads, disseminates throughout your body. Some people might have neurological symptoms. Some people might have arthritis symptoms, some people might have cardiac symptoms. And that’s when it becomes tricky because the bacteria has all sorts of little mechanisms in place that can help it evade your immune system. Can help it sort of evade antibiotic therapies, it’s really quite an impressive little organism. Unfortunately. It just can be very dangerous to humans in the way that it does all that stuff.
If you get out of that early treatment window, that’s when things tend to become more difficult and more problematic for people, and people can develop long term, very debilitating illnesses. And when they do try to treat those stages, because of all these mechanisms that the bacteria is employing to evade the immune system and to evade antibiotic therapies, you might have to go through very prolonged, difficult treatments as well in order to really kind of get better and start to deal with some of the effects of that long term infection.
Jordan Heath-Rawlings: So check carefully and then act quickly.
Justin Wood: Absolutely. I’d say that’s a great summary of the message.
Jordan Heath-Rawlings: Thanks so much, Justin. This has been really informative.
Justin Wood: My pleasure.
Jordan Heath-Rawlings: Justin Wood is the founder of Geneticks. That was The Big Story, for more from us head to thebigstorypodcast.ca. Find us on Twitter at @TheBigStoryFPN, and email us at thebigstorypodcast, all one word, @rci.rogers.com [click here!]. You can also find us in any podcast player you prefer. You can listen to all our shows there. You can subscribe, you can like, you can follow, you can do whatever they call it to show your appreciation. And we’ll appreciate that.
Stefanie Phillips is the lead producer of The Big Story. Other producers are Claire Brassard, Ryan Clarke, and Joseph Fish. I’m Jordan Heath-Rawlings, thanks for listening, we’ll talk tomorrow.
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