Looking at Lyme

Sarah is excited to announce a new Educator Resource for Lyme disease, and speak with the lead resource developer, Lauren Hudson. Lauren is an educator and parent with a passion for science, life and for going into nature with her students and her family. She took a deep dive into the world of Lyme disease to help develop an educator resource to help other teachers both learn and teach about ticks and tick-borne illnesses. Lauren recalls her own journey of learning about tick-borne illnesses from members of the Lyme Education Awareness and Prevention (LEAP) team, through her own research and by listening to the podcasts in Season 1 of the Looking at Lyme. 

Lauren helped develop the Educators’ Resource as a tool to empower teachers to learn and teach others about ticks and tick-borne illnesses. The resource consists of three modules along with three activities per module and numerous slides and images to compliment the written material. The initial resource covers information about ticks and how to identify them, what people need to know before and after going outdoors, as well as the basics of Lyme disease. She points out that it can be used not only by educators in schools, but also in other settings such as outdoor education. It has also been designed to be accessible to diverse ways of learning and different learning styles.

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What can employers do to protect staff who work in the outdoors? In today’s podcast, Sarah explores some answers to that question with Tim Tchida, Owner and CEO of Summit Reforestation in Smithers BC. When Tim first heard about Lyme disease, he never imagined getting the disease himself. Tim recalls first learning he had Lyme disease after receiving a positive Canadian Lyme test (western blot) following mild symptoms of the disease. As time went on, he realized how fortunate he was to receive a diagnosis in light of so many others who have found it very challenging to receive a Lyme diagnosis in Canada. 

Tim acknowledges those who may go for years or even decades, seeing multiple physicians simply to receive a correct diagnosis. He believes that international labs such as Armin lab in Germany, are able to provide more accurate and appropriate testing. Unfortunately, Tim soon came to realize that many physicians did not acknowledge how serious Lyme disease and co-infections can be. As a consequence, he was unable to receive adequate treatment in Canada, and sought treatment in both the United States and Germany, which to date has cost him over $300,000.00. Although grateful to have the resources to seek treatment outside of the public health system, he points out that many people are unable to do so.

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This week, we are very excited to speak with one of Canada’s foremost tick and Lyme disease researchers, Dr. Vett Lloyd, who heads up a dynamic research team at Mount Allison University in Sackvillle, New Brunswick. Her curiosity, passion for community and collaboration and sense of humour have endeared her to her colleagues and her community.

Dr. Lloyd recalls her initiation into the world of Lyme disease when she removed a black legged tick from her shoulder after doing some gardening. She contacted her local public health department and was informed that there were no ticks in New Brunswick. She sent the tick to be tested, but when she followed up with public health, she was told that because there were no ticks in her area, they had disposed of it. Fortunately, Dr. Lloyd received advice from colleagues in western Canada and sought treatment for the symptoms of Lyme disease which followed the tick bite. It was after that personal encounter with Lyme disease that she shifted her research in molecular biology from cancer to studying ticks.

Although most of us cringe at the idea of receiving ticks in the mail, this is how Dr. Lloyd starts a typical day in her lab. She is currently working on a community science initiative in which people send ticks they find on themselves or preferably on pets or other animals. Her research team tests the ticks for various pathogens, a process which takes about two weeks. She notes the importance of ensuring ticks are dead before mailing them, and recommends placing them in the freezer for several days prior to shipping. For shipping, Dr. Lloyd also recommends placing the ticks in two containers, noting that the containers found in the CanLyme tick kits work well for that purpose. Dr. Lloyd requests information about the geographical location of the tick collection and an email address from the sender so that she and her team can notify the sender of the test results.

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As Dr. Maloney says, “Research is our way out of this.” This is our kind of expert leading the way in the field. In today’s podcast, Sarah explores a comprehensive (and free!) online education program designed for healthcare professionals, which was founded by Lyme disease expert, Dr. Betty Maloney. 

Dr. Maloney became interested in Lyme disease when she realized that what she was seeing in her medical practice did not align with her medical training and scientific education. This led her to apply her clinical skills, listen carefully to her patients, and eventually help educate other physicians regarding Lyme disease. It inspired her to support patients through her work with the Minnesota Lyme Association. 

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• Lyme CME (free, evidence-based, AAFP-accredited courses that physicians can trust)
• Economic Impact of Lyme (Zhang et. al., 2006)
• Health Care Costs, Utilization and Patterns of Care following Lyme Disease (Adrion, Aucott, Lemke & Winer, 2015)

Welcome back to Season 2 of the Looking at Lyme podcast. Buckle your seatbelts, because we are going on a science adventure with Dr. Theoharis Theoharides, Professor of Immunology at Tufts University School of Medicine in Boston. Dr. Theoharides has been on the leading edge of mast cell research and recounts the fascinating history and physiology of mast cells. Mast cells have existed for over a hundred million years in many different animals and organisms and are found in all body tissues, including the brain. Mast cells are found in worms, fish, lizards; however, these species do not get allergic reactions. So why are mast cells associated with allergic reactions?

Dr. Theoharides explains that mast cells became associated with allergies in 1947 when it was discovered that they contained histamine. He describes the activation of mast cells during anaphylaxis as the sudden release of about 50 molecules from inside these cells, followed by a delayed release 6-12 hours later of further, newly synthesized molecules. He reflects on his earlier research showing that the release of these molecules can also occur, not only with allergies, but also due to many pathogenic, environmental triggers (for example, mold), and stress hormones. He notes that triggers such as Borellia or mold can cause the release of only cytokines (not histamine, or tryptase) from the mast cells. Dr. Theoharides also explains that when mast cells are “primed” with interleuken 33, followed by stress hormone release, the mast cells can release more pro-inflammatory cytokines than any other type of immune cell. This massive release of cytokines is referred to as a “cytokine storm”.

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• Molecular Immunopharmacology & Drug Discovery Laboratory
• Recent Publications from the Theoharides Lab

Well that was fun! And did we ever learn a lot from season one. We feel very fortunate to have interviewed so many incredible doctors, scientists, journalists, and educators. It was a really interesting year to deepen our understanding about tick-borne illnesses. We're at the end of season one, and we'll be back with season two in 2021. 

We've just released the first draft of a teacher resource. Please share it with any educators or guides that you might know. 

Thank you for your support. Stay safe in the outdoors!

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Educators' Resource, 2020

www.lookingatlyme.ca

In today’s podcast, Sarah talks about ticks, Lyme disease and climate change with investigative reporter Mary Beth Pfeiffer. She lives in New York State, an area of the US which is highly endemic for Lyme disease, and has been investigating this disease for the past 8 years. Her search for answers revealed that there was not only a denial from the US CDC and Infectious Diseases Society of America (IDSA) regarding what patients were telling them about Lyme disease but also a disdain for this patient population. Mary Beth describes how her own book, Lyme: the First Epidemic of Climate Change, evolved out of her interest in Lyme disease and her passion about climate change. Mary Beth describes some of the research that shows how tick populations are migrating into both higher altitudes and latitudes (northward into Canada). 

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In today’s podcast, Sarah examines the importance of adequate training in wilderness first aid skills. She speaks with expert Michael Crawford, an instructor at Slipstream Wilderness First Aid in Victoria, BC. Michael points out some of the differences between regular first aid and wilderness first aid. Anyone performing first aid on a patient in a wilderness setting will likely need to care for them for a longer period of time than in a city situation. It is also important to know and differentiate between which health issues need to be addressed immediately and those that can wait.

In the courses, he emphasizes the importance of prevention to avoid potential health risks. Michael advises outdoor leaders to teach participants a daily tick checking routine in order to reduce their risk of contracting Lyme disease. This training includes knowing what ticks look like at different stages of their life cycle and where they are more likely to attach on humans. 

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In this podcast, Sarah speaks with Steve Smith, an expert in outdoor risk management. Steve has worked for many years teaching, leading, planning, and consulting about ways to manage risk in the outdoors. Steve recently presented at the 2020 NOLS Wilderness Risk Management Conference.

Steve begins by explaining the difference between safety and risk management, and why this distinction is necessary when it comes to taking people into the wilderness. Every day we take risks and some degree of risk is not only unavoidable, it’s a necessary part of being human. Sarah and Steve discuss many of the benefits of how outdoor education and recreation translate to life skills, personal and social growth. Steve speaks about the history of Outward Bound and founder Kurt Hahn who taught about the importance of educating the whole student and encouraging them to explore beyond their comfort zones. It is an important component of developing and managing outdoor education programs, looking at the beneficial risks and identifying and mitigating the undesirable risks.

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In this episode Sarah talks with Canadian researcher Dr.Leona Gilbert, originally from Thunder Bay, and currently living in Finland. Dr. Gilbert tells us about an interaction with a patient that led her to focus on testing for Lyme disease. She points to research showing that patients who suffer from long term effects of Lyme disease often test positive for multiple microbes. 

Tickplex is a diagnostic kit that tests for six different forms of borrelia, ten other forms of microbes as well as antibodies which correlate to three different disease stages - all in one test! Dr. Gilbert explains the benefit to this method (also known as polymicrobial theory) over testing for one microbe with one antibody at a time. She points out that many long time sufferers of Lyme disease and co-infections are unable to build an adequate immune response to these microbes, but with treatment their immune system starts to respond and is then able to create antibodies. Research is also showing that outcomes are much better for those patients who are diagnosed early, tested for multiple microbes and then treated. She also talks about how multiplex testing is identifying patients who are “shining up” due to a hyperactive immune system.

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