2021-09-08

Pharmacists now allies in the fight against Lyme disease

Local Journalism Initiative Reporter

While leaves may be falling from the trees now, heralding in a new, chillier season, it doesn't mean one can forget about being concerned about ticks and Lyme disease, according to experts.

However, Nova Scotians now have an ally in the fight against the debilitating disease in the form of the province's pharmacists.

As of last month, pharmacists have been able to make initial assessments of someone who has encountered a tick and is concerned or suspects they may get Lyme disease as a result, and they are able to prescribe medication that may help prevent it.

With 300 pharmacies and 1,400 pharmacists added to the front line to combat the disease, there is more hope that the threat can be managed.

Diane Harpell, Chair of the Pharmacy Association of Nova Scotia (PANS) and owner of the Medicine Shoppe in Nova Scotia, was pleased to be able to provide this service for people. "We are a profession that is really aimed at trying to make sure our patients are properly taken care of."

If someone catches a tick biting them, Harpell suggests getting in contact with a pharmacist who will instruct the patient on how to use tweezers to properly remove it. Once the tick is removed, Harpell suggests, the victim put the tick in a freezer bag and takes it to the pharmacy.

The pharmacist would identify the tick and determine if it is the type that typically carries the bacteria that causes Lyme disease. The patient would also be asked questions about where it's suspected the tick was picked up, when, and how long it may have been attached.

In general, it takes about 36 to 48 hours for the bacteria to enter the bloodstream after a tick bite. If a tick is removed during that time, the risk of getting Lyme disease is substantially lowered.

If the patient fits a certain set of criteria for possible Lyme disease, such as confirmation that it is a deer tick and the timeline is right, the pharmacist will prescribe an initial treatment, "to try and prevent it from happening," said Harpell.

The treatment would come in a prophylactic form, consisting of a one-day course of doxycycline, with the dosage specific to the patient as per any prescribed medication.

If the bite does not fit the criteria, it would be a wait-and-see scenario and the pharmacist would then follow-up with the patient.

If there is a bull's-eye rash, which is often symptomatic of a Lyme infection, Harpell said, they are no longer talking about prevention and the patient would be referred to a physician.

Preventing tick bites in the first place is key to the fight against Lyme. Harpell said the first and most obvious way in doing this is to avoid areas with high grass, tuck in your pants, wear light clothing so you can see ticks easily, use products with DEET and perform regular tick checks.

Not a panacea

While having pharmacists onside in the battle against Lyme disease, Dr. Rob Murray, a retired Lunenburg dentist who is a member of the Canadian Lyme Disease Foundation, suggests it won't be a panacea by any means.

After contracting Lyme disease himself, he has spent years studying the disease and solutions.

Although he's in favour of having more people able to assess and try to prevent Lyme, he suggests it may do more harm than good. He maintains there is much more to it than treating a tick bite and a swollen dot on an arm. He notes that only about 10 per cent of tick bite patients show the bulls-eye rash.

Murray opines, "You don't treat anything with one or two pills like they're suggesting. What they're trying to do is prophylactically prevent disease with one or two pills, but that is really questionable logic." "This is not as happy a solution as they're pretending – one pill and they're done because now you're going to test negative for the rest of your life because you've never developed the antibodies to it." Twelve to 18 months after being bitten by a tick, according to Murray, people may start showing symptoms such as hearing loss or worsening eyesight, which may eventually appear as Alzheimer's, Amyotrophic lateral sclerosis (ALS) or Multiple sclerosis (MS) and may be misdiagnosed as depression or other psychological issues.

Murray would like to see better testing and more research done, possibly with tissue banking so more studying on the effects of Lyme can be accomplished. He's been working hard to make tick bites and Lyme disease a bigger priority within the medical field.

"This is a research-disadvantaged field." Treating complex Lyme and tick-borne infections "should be a medical specialty of its own," he says, adding that ticks can carry up to five infections from just one tick bite.