https://www.cbc.ca/news/canada/manitoba/tick-bourne-lyme-disease-service
‘Virtual clinic’ of specialists focused on Lyme disease diagnosis, treatment expected to open early next year
Program will connect primary health providers, patients to specialists to help treat tick-borne illnesses

Winter may be around the corner, but Manitoba health officials are already focused on treating a summer hazard — tick-borne illnesses like Lyme disease.
A “virtual clinic” of medical health officers focused on better diagnosing and treating tick-borne illnesses, first announced by the Manitoba government last June, is expected to be operating by early next year, says Dr. Richard Rusk, the province’s medical health officer for communicable disease control.
“If you have someone with multiple issues and symptoms and they don’t really come up with a clear diagnosis, then they are lost — so how do you look after this group?” said Rusk.
Symptoms, which typically appear from three to 30 days following the bite of an infected black-legged tick, can include fever and muscle aches, but if untreated, infection can spread to the joints, heart and nervous system, according to the province’s website.
Rusk says tick-borne illnesses can be difficult to diagnose, and the new collaborative program is meant to help primary physicians by connecting them with specialists.
“It often involves intense evaluations, which is why your average family physician won’t be able to do this,” he said.

“The team consists of an infectious disease specialist, a neurologist, an internal medicine specialist, a rheumatologist, a psychiatrist and physiatrist, so it’s a fairly high-level group of specialists,” said Rusk. A primary health care nurse and pharmacist will also be on the team.
Some patients who are already working with an internal medicine specialist are starting to be seen by the other medical experts as a trial run of the program. But software and administrative details are still being worked out before the official rollout of the virtual clinic.
“We’re looking to take in 10-12 patients a month, because it’s complex and each patient probably takes about two hours just with the internal medicine specialist, never mind the other experts,” says Rusk.
He says the Manitoba tick-borne collaborative care service will also be part of the Canadian Lyme Disease Research Network.
Dr. Kieran Moore is the Ontario medical health officer tasked with bringing together a cross-country network of university researchers, medical specialists, and patients to fill gaps when it comes to research, diagnosis, treatment and education.
“We’ve got a lot of catch-up on education on the clinical signs and symptoms, as well as testing reliability and treatment pathways,” says Moore, who is also a professor of family and emergency medicine at Queen’s University.
There are plans to include Manitobans in research efforts, but that is still two or three years away.
“We have to get protocols set in [Ontario] and then in Halifax, and then we will expand,” said Moore.