Question Period Note: Lyme disease

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• Lyme disease continues to draw public, political, and media attention with particular scrutiny on the number of human cases, risks, diagnosis, and treatment in Canada. The incidence of Lyme disease in Canada is steadily increasing. There is increasing evidence that the emergence of Lyme disease in Canada was driven by changes to temperature and precipitation, making Canada more suitable for the ticks that carry the disease.
• Our Government recognizes that cases of Lyme disease are increasing in Canada, due in part to climate change.
• We are committed to collaborating with new and existing partners to expand our reach and deliver new products, programs, and information for Canadians.
• We are raising public awareness of Lyme disease and other climate-driven infectious diseases and making sure health care providers have the information they need to recognize the symptoms.
• We are funding research on the diagnosis and treatment of Lyme disease to support early detection and care.

If pressed on the Evaluation or Final Report of the Federal Framework on Lyme Disease
• We will continue to work to strengthen efforts on Lyme disease by building on the accomplishments of the Framework and applying the lessons learned.
• We will ensure that there is continued engagement with stakeholders to provide opportunities for them to share their expertise, input, and experience.
• We are committed to continuously improving our understanding through ongoing research and innovative projects that address the impact of climate change on human health.
• Promoting education and awareness materials for target audiences, including health professionals to support prevention and early diagnosis will also remain a priority.

The Public Health Agency of Canada (PHAC) monitors Lyme disease in Canada. PHAC provides national information on the number of cases reported and identifies where Lyme disease is present and emerging in Canada. Addressing Lyme disease is a shared responsibility. In partnership with public health authorities at other levels of government, the Government of Canada is raising awareness through public education; supporting surveillance activities and national reporting; conducting and supporting laboratory diagnostic testing; engaging with international and domestic organizations; and funding research. Provinces and territories (PTs) provide healthcare services to Lyme disease patients and coordinate prevention and control activities.

Government of Canada Actions and Investments

Federal Framework on Lyme Disease
The five-year Federal Framework on Lyme Disease was published on May 30, 2017. A report on the Framework was tabled in the House of Commons on June 10, 2022. The Framework has focused efforts on tracking the incidence of Lyme disease nationally, increasing awareness among Canadians and front-line health professionals, monitoring the distribution and expansion of risk areas in Canada, and supporting provincial laboratories and numerous science, innovation, and research initiatives.

There was no dedicated funding for the implementation of the Framework.

Audit and Evaluation
PHAC’s Office of Audit and Evaluation (OAE) conducted an evaluation of PHAC’s framework activities. OAE conducted 47 interviews with a range of key informants including representatives from organizations for people with lived experience, researchers, government representatives, professional associations, and subject matter experts. The online survey was completed by 91 respondents, with 53% of them being persons with lived experience or groups representing people with lived experience.
The evaluation found that progress was made in implementing the Framework, most notably under the Education and Awareness pillar. Many activities under the Surveillance and Guidance and Best Practices pillars were also advanced. This work resulted in new and innovative tools and resources, which were seen as highly valuable by the scientific community and other federal, provincial, and territorial partners. Persons with lived experience identified continued unmet needs in the areas of surveillance, diagnosis, and treatment for Lyme disease, particularly for individuals who do not fit the case definition.
Over the next few months, PHAC will complete the remaining items in the Framework to achieve full implementation.
Canadian Lyme Disease Research Network
In October 2018, Canadian Institutes of Health Research and PHAC invested $4 million over 4 years in the Canadian Lyme Disease Research Network (CLyDRN). CLyDRN brings together Lyme disease stakeholders, including researchers, clinicians, and patients in order to facilitate national collaboration and to generate new knowledge to improve the diagnosis, treatment, and health outcomes for people with Lyme disease.

Infectious Diseases and Climate Change Fund
PHAC’s Infectious Disease and Climate Change Fund provides $2 million annually over 11 years (2017-2028) to help Canadians, communities and health professionals have the information they need to better understand their risks and take measures to protect themselves from climate-driven infectious diseases. To date, almost $5 million in funding has been invested to support 15 new Lyme disease projects focussed on enhancing surveillance and monitoring efforts, and developing new education and awareness resources and tools for the public and health professionals.

• Caused by the bite of an infected blacklegged tick, early symptoms of Lyme disease can include a rash at the site of the tick bite (sometimes shaped like a bull’s eye), fever, chills, fatigue, headache, swollen lymph nodes, and muscle and joint pain. Long-term symptoms can include neurological problems, chronic pain, and fatigue.
• If diagnosed early, Lyme disease can be effectively treated with antibiotics.
• The number of regions with established blacklegged tick populations continue to increase across Canada.
• Between 2009 and 2021, provincial public health units have reported 14,616 human cases of Lyme disease across Canada.
• 92% of human Lyme disease cases from 2009 to 2019 were from Ontario, Quebec, and Nova Scotia.
• The provinces reported 2,851 cases of Lyme disease in 2021, compared to 1,615 cases in 2020. This is the highest annual number of cases reported since Lyme disease became notifiable in 2009.
• Public education and raising awareness is key to prevention and early detection.