EPIDEMIOLOGIC REPORTS * ETUDES EPIDEMIOLOGIQUES
Lyme disease in Canada T he lack of a standard surveillance case definition for Lyme disease and of uniform criteria for laboratory confirmation have made it difficult to interpret the available data on the occurrence of the disease in Canada. It has been even more difficult to compare data between provinces. To help improve the quality of the available data the Communicable Disease Subcommittee of the Advisory Committee on Epidemiology is developing a standard Canadian surveillance case definition for Lyme disease.* This new definition will include criteria for laboratory confirmation, which are being defined by the Technical Advisory Committee. The implementation of the new case definition will assist in obtaining a much better picture of
of Lyme disease that were known to them. At present the disease is only notifiable in Ontario and Nova Scotia. Newfoundland: One case was reported in 1989. It was not acquired in the province. New Brunswick: Five cases were reported in 1989; only one was believed to have been acquired in New Brunswick. The onset of illness was in 1987 in one, 1988 in another and 1989 in three. Quebec: One case was reported in 1989. Ontario: A total of 67 cases were reported, 39 of which were acquired in Ontario. Of the 39 cases 10 (26%) were reported from 1984 to 1987, 8 (20%) in 1988 and 21 (54%) in 1989. Manitoba: Seventeen cases were reported that met the surveillance case definitions in use in Manitoba at the time. Five cases were reported in 1988 and 12 in 1989. Alberta: One case was reported in 1989. British Columbia: Eleven cases were reported: 1 in 1988, 9 in 1989 and 1 in 1990. In 10 of the cases the people had travelled to endemic areas outside of the province and may have acquired the disease while there. The investigation on the remaining case is continuing. There are no documented cases of Lyme disease from Prince Edward Island, Nova Scotia, Saskatchewan, the Northwest Territories or the Yukon Terri-
the disease in Canada. In the meantime the Laboratory Centre for Disease Control (LCDC) has received many requests for information on the occurrence of Lyme disease in Canada. The public has become increasingly concerned, mainly because of information from the United States, where about 7400 cases were provisionally reported in 1989.1 To help allay fears that a similar situation exists in Canada LCDC feels that it is important to publish the currently available data, which reveal the existence of about 100 cases. However, given the previously mentioned limitations these data must be interpreted with caution. Furthermore, the application of the new case defini- tory. tion may well affect the estimate of the prevalence of Lyme disease in Canada. The help of the provincial and territorial epidemiologists
Provisional data In June 1990 the provincial and territorial epidemiologists provided information on the cases *The criteria for a surveillance case definition are not necessarily appropriate for a clinical case definition.
in providing information on the cases known to them and information on whether Lyme disease is notifiable in their jurisdictions is gratefully acknowledged.
Reference 1. Tickborne diseases
-
Georgia, 1989. MMWR 1990; 39: 397-
399
Based on material previously reported in Canada Diseases Weekly Report (a publication of the Bureau of Communicable Disease Epidemiology, Laboratory Centre for Disease Control, Department of National Health and Welfare, Tunney's Pasture, Ottawa, ON KIA OL2) by Susan G. Mackenzie, PhD, Disease Surveillance Division, Bureau of Communicable Disease Epidemiology (1990; 16: 141-142). Publication in CMAJ is with permission of the author and the bureau. Reprint requests to: Dr. Susan G. Mackenzie, Disease Surveillance Division, Bureau of Communicable Disease Epidemiology, Laboratory Centre for Disease Control, Tunney's Pasture, Ottawa, ON KIA OL2 CAN MED ASSOC J 1991; 144 (2)
177
Lyme disease in Canada T he lack of a standard surveillance case definition for Lyme disease and of uniform criteria for laboratory confirmation have made it difficult to interpret the available data on the occurrence of the disease in Canada. It has been even more difficult to compare data between provinces. To help improve the quality of the available data the Communicable Disease Subcommittee of the Advisory Committee on Epidemiology is developing a standard Canadian surveillance case definition for Lyme disease.* This new definition will include criteria for laboratory confirmation, which are being defined by the Technical Advisory Committee. The implementation of the new case definition will assist in obtaining a much better picture of
of Lyme disease that were known to them. At present the disease is only notifiable in Ontario and Nova Scotia. Newfoundland: One case was reported in 1989. It was not acquired in the province. New Brunswick: Five cases were reported in 1989; only one was believed to have been acquired in New Brunswick. The onset of illness was in 1987 in one, 1988 in another and 1989 in three. Quebec: One case was reported in 1989. Ontario: A total of 67 cases were reported, 39 of which were acquired in Ontario. Of the 39 cases 10 (26%) were reported from 1984 to 1987, 8 (20%) in 1988 and 21 (54%) in 1989. Manitoba: Seventeen cases were reported that met the surveillance case definitions in use in Manitoba at the time. Five cases were reported in 1988 and 12 in 1989. Alberta: One case was reported in 1989. British Columbia: Eleven cases were reported: 1 in 1988, 9 in 1989 and 1 in 1990. In 10 of the cases the people had travelled to endemic areas outside of the province and may have acquired the disease while there. The investigation on the remaining case is continuing. There are no documented cases of Lyme disease from Prince Edward Island, Nova Scotia, Saskatchewan, the Northwest Territories or the Yukon Terri-
the disease in Canada. In the meantime the Laboratory Centre for Disease Control (LCDC) has received many requests for information on the occurrence of Lyme disease in Canada. The public has become increasingly concerned, mainly because of information from the United States, where about 7400 cases were provisionally reported in 1989.1 To help allay fears that a similar situation exists in Canada LCDC feels that it is important to publish the currently available data, which reveal the existence of about 100 cases. However, given the previously mentioned limitations these data must be interpreted with caution. Furthermore, the application of the new case defini- tory. tion may well affect the estimate of the prevalence of Lyme disease in Canada. The help of the provincial and territorial epidemiologists
Provisional data In June 1990 the provincial and territorial epidemiologists provided information on the cases *The criteria for a surveillance case definition are not necessarily appropriate for a clinical case definition.
in providing information on the cases known to them and information on whether Lyme disease is notifiable in their jurisdictions is gratefully acknowledged.
Reference 1. Tickborne diseases
-
Georgia, 1989. MMWR 1990; 39: 397-
399
Based on material previously reported in Canada Diseases Weekly Report (a publication of the Bureau of Communicable Disease Epidemiology, Laboratory Centre for Disease Control, Department of National Health and Welfare, Tunney's Pasture, Ottawa, ON KIA OL2) by Susan G. Mackenzie, PhD, Disease Surveillance Division, Bureau of Communicable Disease Epidemiology (1990; 16: 141-142). Publication in CMAJ is with permission of the author and the bureau. Reprint requests to: Dr. Susan G. Mackenzie, Disease Surveillance Division, Bureau of Communicable Disease Epidemiology, Laboratory Centre for Disease Control, Tunney's Pasture, Ottawa, ON KIA OL2 CAN MED ASSOC J 1991; 144 (2)
177
