History and advocacy of Lyme disease in Canada

2024 marks the 20th Anniversary of the Canadian Lyme Disease Foundation. For the past two decades CanLyme has advocated for patients by supporting an approach that reflects emerging research and expertise from across the globe, and considers the realities experienced by Canadian patients and their healthcare providers.

Despite the combined efforts of CanLyme and other advocacy groups, many Lyme patients are unable to receive the diagnosis and treatment they need within the Canadian healthcare system. 

The history of Lyme disease controversies and advocacy efforts have been the subject of many books and documentaries over the years. The following is a snapshot of significant events and Lyme disease advocacy milestones over the past five decades. 

Lyme disease is a global problem

For the past forty years there has been ongoing debate about the testing, diagnosis, treatment and even the definition of Lyme disease. From one viewpoint the testing and treatment protocols we have are for the most part adequate. The reality is that many patients are unable to receive a diagnosis and proper treatment for this disease, and are left seeking solutions on their own. 

This is a global problem, one which is currently being addressed by advocacy groups around the world. As a result of inadequate testing and treatments for Lyme patients, groups and organizations have formed to help support patients and advocate for change.

Borrelia: an ancient pathogen

DNA that can be traced to the bacterium causing Lyme disease have been found in a 5000 year old mummified man and as long as 60,000 years ago in North America.1 Skin manifestations similar to those of Lyme disease were documented in the late 1800’s and early 1900’s in Europe.

1970’s: Mothers from Lyme Connecticut raise alarms

In the mid 1970’s two mothers in Lyme Connecticut noticed that many people, including many children, were experiencing similar but mysterious symptoms. One of those mothers, Polly Murray, gathered this information and brought it to the attention of health authorities. She continued to advocate to raise awareness about this new disease.

1980’s: Lyme bacteria found in Canada

Borrelia, the bacteria that causes Lyme disease, was identified in the BCCDC laboratories around 40 years ago, in the 1980s, by Drs. Satyen and Maya Banerjee. The Lyme Borreliosis Society of BC was formed in 1989 to address this emerging disease. In the same year there were 93 cases of Lyme disease in Manitoba, 51 of those had a bullseye rash. In the late 1980’s, a number of articles were written that described the complexity of Lyme disease, including the chronic nature of the disease, its neurological manifestations and maternal-fetal transmission of the disease.2

1990’s: Provincial advocacy and patient support groups formed

The Lyme Disease Association of Ontario was founded in 1990. Two Lyme disease conferences were held in Canada in the 1990’s – one national and one international. Several Lyme disease groups were formed, including Ontario, Manitoba, Saskatchewan and New Brunswick.

Meanwhile, in the US, the Infectious Diseases Society of America, or IDSA, established their two-tiered testing protocol. This test shaped the history of Lyme disease in the US, Canada and other parts of the world. It has been used to direct research along with the diagnosis and treatment of Lyme disease. This has placed limitations not only on the research that has been done, but also on which patients receive treatment and how physicians approach the diagnosis and treatment of the disease. 

In 1999 the International Lyme and Associated Diseases Society, or ILADS, was formed to address this limiting approach. 

2000’s: Guidelines are published and CanLyme is formed

In 2000 the IDSA published their first set of guidelines for the diagnosis and treatment of Lyme disease. In 2001 the US Lyme Disease Association (LDA) published a report to illustrate  financial and other conflicts of interest involving authors of the IDSA guidelines. 

In 2003 the Canadian Lyme Disease Foundation, CanLyme, was formed as a national patient support group based in BC. In 2004 ILADS published their first set of guidelines. In 2006 the Public Health Agency of Canada held a conference. Dr. Daneil Cameron, Dr. Sam Donta, Dr. Harris from Igenex and lawyer Lorraine Johnson attended. A report was published two years later. None of the recommendations from the conference were enacted.

Throughout the 2000’s, new guidelines were published by the IDSA, explicitly denying chronic Lyme disease. Advocacy groups, including CanLyme, the Lyme Action Group in Ontario, and ILADS and the LDA in the US continue to advocate for better testing and treatments. 

In 2009, 17 US States enacted legislation and other initiatives to protect doctors who treat chronic Lyme disease. Canada has never taken this approach; several Canadian physicians have been investigated for treating Lyme patients who are not cured by short courses of antibiotics. Canadian clinicians who treat patients with chronic Lyme disease continue to report increased scrutiny. This is very problematic for clinicians and for all Lyme patients in Canada.

2010’s: Federal Lyme conference held and framework is developed

Lyme advocacy groups continued to form across Canada. Rallies were held, patient groups were formed to support those who were unable to receive proper diagnosis and treatment, and advocates and politicians raised their concerns in provincial and federal parliaments. Bill C442, a private members bill tabled by Elizabeth May, was passed, and in 2016 the Conference to develop a federal framework on Lyme disease was held.3

During the 2016 Conference, scientists, doctors, politicians were asked to speak, along with hundreds of Lyme patients from across the country. Patients described the challenges they faced in receiving a diagnosis and adequate treatment. Many also described the difficulties they had in gaining access to effective health care, paying out of pocket for treatments outside the public healthcare system, and being disbelieved by their doctors, and sometimes their family and friends.

As a result of the conference, the Federal Framework on Lyme Disease was drafted. Patients, advocate groups and researchers vocalized their disagreement with many of the recommendations laid out in this document, leading to roundtable discussions involving these stakeholders along with government and public health officials.4 Unfortunately, many of the issues raised during these discussions have still not been addressed. CanLyme, along with other advocacy groups in Canada, continue to work toward effective solutions.

2020’s: Advocates continue to raise awareness and work toward solutions

Advocates continue to bring awareness and seek solutions to the problems faced by Canadian patients and their healthcare providers. They continue to raise awareness about Lyme and other tick-borne diseases, support people who are suffering with the disease and educate the public in order to prevent tick bites and promote early diagnosis and treatment.

For more detailed information of the history and advocacy of Lyme disease in Canada, explore CanLyme’s Lyme Disease Timeline.

Footnotes

  1. Ancient History of Lyme Disease in North America Revealed with Bacterial Genomes
  2.  History of Lyme disease in Canada 1985-2009 retrieved from:  Ferrie, H. (2010). Ending Denial: The Lyme Disease Epidemic: A Canadian Public Health Disaster. Caledon, On, Canada: KOS Publishing Inc.
  3.  Summary Report of the Conference to develop a federal framework on Lyme disease, May 15-17, 2016
  4.  Multidisciplinary Roundtable Discussion on Lyme Disease Session Report