May is Lyme Disease Awareness Month, a global initiative targeted at raising awareness of this debilitating condition. The fact that most people—and employers—aren’t familiar with the disease, its symptoms and treatment options indicates that a campaign to raise its profile is needed, especially as the incidence of Lyme disease in Canada is expected to grow.
A paper published recently in the Journal of Applied Ecology noted that a substantial increase in Lyme disease risk is possible “with the proportion of the human population of Eastern Canada inhabiting areas with established tick populations increasing from 18% in 2010 to over 80% by 2020.”
The effect on employers
With such rampant possibility of infection, employers may well want to increase their knowledge of the disease. For some roles in some industries, taking steps to minimize the chances of employees contracting Lyme disease is an occupational health and safety best practice.
Lyme disease is caused when a tick bites and transmits the Borrelia burgdorferi bacterium as it sucks the blood of its host. There are a number of wide-ranging symptoms—everything from fatigue, headaches, neurological problems, mental impairment, and joint and muscle pain to life-threatening brain and heart infections.
An employee who receives a false negative Lyme disease diagnosis will likely be referred to a variety of specialists and may face expensive tests, medications and hospital stays—paid for by the healthcare system—in order to obtain relief.
Even if the employee is able to return to work, a relapse may occur. Without an official diagnosis, employers, co-workers and insurers may believe that the employee is malingering. He or she may face dismissal and/or have a hard time collecting disability benefits.
David Share, president of Share Lawyers, calls Lyme disease one that the insurance industry considers to be “an invisible medical condition” such as fibromyalgia, where others may believe patients’ symptoms “are all in their head.”
However, he readily acknowledges that this reaction may be understandable.
“Without a definitive medical test to confirm a diagnosis of Lyme disease, as well as unpredictable symptoms, a patient’s claim may be met with ‘healthy skepticism’.”
Share’s firm has been successful in obtaining benefits for employees without a specific diagnosis where “the evidence has suggested the claimant is highly credible and motivated to get better.”
Passing the test
There is no universally accepted test for Lyme disease. The national standard required in Canada is a two-tier process to confirm the diagnosis. Jim Wilson, president and founder of the Canadian Lyme Disease Foundation (CanLyme), believes that testing in this country is not keeping pace with emerging scientific findings regarding Lyme disease.
“While screening in Canada has been broadened in the last two years to test for European strains of the bacteria known to cause Lyme disease, the confirmative western blot test still checks for the presence of only one particular strain, completely negating the value of screening improvements,” he explains.
In October 2012, Health Canada itself issued an advisory in its Canadian Adverse Reaction newsletter warning about the sensitivity and specificity limitations of Lyme disease test kits.
Many Canadians who suspect they have Lyme disease, despite negative test results, head south of the border—at their own expense—for additional testing, diagnosis and treatment. Several U.S. states have specialist Lyme-literate doctors who are experienced with diagnosing and treating Lyme disease based on clinical history and symptoms.
And if testing is controversial, so is treatment. The general course of action is to treat Lyme disease with antibiotics. Full recovery is possible if the disease is caught early and treated appropriately.
However, Lyme disease sufferers who go untreated (or are insufficiently treated with too short a course of antibiotics) may experience persistent symptoms that manifest with greater severity and develop into chronic Lyme disease, requiring long-term ongoing treatment.
Antibiotics are not always successful in treating chronic Lyme disease, however. As a result, some Lyme disease sufferers turn to herbal remedies, a restricted diet, supplements and other experimental treatments not currently covered under provincial healthcare.
Recommendations for employers
CanLyme says vigilance is required for organizations with employees who work outdoors. Workers should wear light-coloured long pants, long-sleeved shirts, and shoes and socks, to cover up and spot ticks more easily. And they should apply insect repellent to skin and clothing. The best course of action is, of course, prevention: employees should avoid tick-infested locations where possible—leafy wooded areas and those with overgrown grass.
Marcia McDougall is a freelance writer and president of InteGreat Marketing PR Events. mmcdougall@integreatmarketing.com