The following information is based on current information on the relevant tick vectors in Canada. The most significant of these ticks from a human health perspective are Ixodes scapularis and Ixodes pacificus . Although I. scapularis have been identified in different regions of Canada, the only place in Canada where this tick species has been shown to be endemic at present is Long Point in southern Ontario which is an identified Lyme disease endemic area. Similarly, the important tick vector I. pacificus is endemic in parts of British Columbia and these have been identified as Lyme endemic
areas. If reports of the Lyme disease bacterium in other ticks species can be substantiated these endemic areas will be expanded.
A disease is made nationally "notifiable" on the recommendation of the advisory committee on epidemiology, ACE. In 1988 a subcommittee of ACE recommended 12 criteria to determine the importance of a disease for making it nationally notifiable. On the basis of these criteria a number of diseases were scored high enough to be included in the list of nationally notifiable diseases; however, lyme disease was not included in this group. The methods, criteria and list of diseases were published in the Canada Communicable Disease Report in 1991, 20 April; vol 17-16.
The process used by ACE recognised that "notification" was not always the most appropriate method for studying the epidemiology of a particular disease and that other approaches such as the use of sentinel reporting sites or laboratory based reporting might provide more meaningful information in some circumstances.
For question (c):
Alberta-3 New Brunswick-9 Quebec-1 Ontario-210 Manitoba-17 Saskatchewan-1 British Columbia-14
The Canadian consensus conference of Lyme disease published in two venues-the Canada Communicable Disease Report and the Canadian Journal of Infectious Disease-initially provided guidelines. Updated information when available has been published in the Canada Communicable Disease Report.
The legal mechanism to ensure reporting of a specific disease is to make it "reportable" and the legal mechanisms for doing this reside at the provincial government level. For a disease to be nationally notifiable requires each jurisdiction to legislate separately for the disease to be "reportable" within that jurisdiction.
Information is made available to the public from health units in the known endemic provinces of British Columbia and Ontario. The Ontario fact sheet is currently being updated.
Question No. 212-