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

Black-legged ticks can spread Lyme disease and other tick-borne illnesses. A new provincial program is intended to help diagnose and treat those illnesses by connecting patients and primary-care physicians with specialists. (Bertrand Guay/AFP/Getty Images)

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.

It’s estimated as many as 1,000 Manitobans may be suffering from tick-borne illness and need help getting diagnosed and treated.The tick-borne collaborative care service, which the province said in a June media release is intended to “streamline and improve health services for patients who show symptoms of late Lyme disease and other emerging tick-borne illnesses,” will receive $240,000 a year. The program will gather a round table of experts in a tele-health format to help diagnose and treat patients.In 2018, there were 70 reported cases of Lyme disease, with  28 confirmed cases and 26 probable cases, according to the province.

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.

Dr. Richard Rusk is the lead on a virtual system that will link family doctors with a team of medical specialist to better diagnose and treat patients struggling with tick-borne illnesses like Lyme disease. (Jaison Empson/CBC)

“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.