Mr. Speaker, I too am pleased to rise in this House today to speak to Bill C-442, because like many other members in this House, I have constituents who have suffered from Lyme disease. Sadly, for many constituents, it has taken them months if not years to get an adequate diagnosis. In the meantime, their lives have been lives of misery, as they simply have not been correctly diagnosed or have not received the proper treatment.
Bill C-442 aims to track the incidence rates, create educational materials to raise awareness about Lyme disease, establish testing and treatment guidelines, and track the related economic impacts of Lyme disease. It would also support the research and implementation of better and more reliable diagnostic testing and increased education and awareness among physicians.
I want to turn for a moment to a Globe and Mail article that was in the paper on April 27. The headline was “Lyme disease on the rise in Canada, linked to ticks”. The subheading is, “This is the first in a series examining health repercussions for Canadians due to a changing climate. First up: Lyme disease”. In the article, the writer notes:
Most Canadians think of Lyme disease as a rare illness that afflicts hikers bitten by ticks in the deep woods. Infected individuals develop a bull's-eye rash and go on antibiotics for a few weeks to clear it up. Problem solved.
The trouble with this picture—promoted for years by Canadian health authorities—is that it does not begin to capture the true threat of Lyme disease, which in its chronic form can turn into a life sentence of debilitating joint pain and neurological problems. Disease-carrying ticks in Canada have increased tenfold in the past two decades, spread by migratory birds and nurtured by warming climates that allow them to thrive in our own backyards. While reported cases jumped 146 per cent between 2009 and 2012, advocates say that testing is inadequate and doctors lack awareness of Lyme, resulting in gross underreporting and under-diagnosis of this rapidly emerging infectious disease.
I can certainly say that on Vancouver Island, some of the response from the medical community has been that Lyme disease does not exist on Vancouver Island, so someone could not possibly have Lyme disease. Of course, when some of the constituents were able to get the testing, outside of Canada, sadly, spending thousands of dollars, it was demonstrated that they did in fact have Lyme disease and then needed to be on prolonged courses of antibiotics to deal with it.
Later in the article, it says:
Detecting Lyme disease is an evolving science, however. Recent studies have shown that different strains of Borrelia, the bacteria that causes Lyme, may target different organ systems, triggering a variety of immune responses. While the responses vary, one strain alone can affect skin, joints, the heart and nervous system.
Canadian health authorities recognize the need to detect different strains of the bacteria, the PHAC [the Public Health Agency of Canada] said in a statement, adding that Canadian labs are using “updated screening tests that are reactive to a much broader range of Borrelia strains”.
Mr. Wilson is with a not-for-profit organization that has been trying to raise awareness. The article continues:
But Wilson said that from what he has heard in the Lyme community, Canadian patients are still being offered the same old tests. The standard Western blot test detects only a lab strain of Borrelia and its close cousin.
The second test, known as the ELISA, isn't sensitive enough to distinguish Lyme from such illnesses as lupus or rheumatoid arthritis, according to Dr. Brian Fallon, director of the Lyme and Tick-Borne Diseases Research Center at Columbia University.
Both are known to have “significant limitations,” Fallon said.
Newer tests available at private U.S. labs can detect all strains and species of Borrelia bacteria. Although these tests have their own pitfalls, “they're really an improvement on the standard tests,” said Fallon, who saw no reason why they should not be widely used in Canada.
The article concluded by stating:
Unless Canada starts doing a better job at detecting Lyme disease..., “we're going to continue to have most people in the chronic category, because they're just not being picked up.”
This has a devastating effect. Certain people talk about the economy, but it has a devastating effect on people and their lives and on their families.
Part of the challenge with this is that, as I mentioned, in Canada, many patients report issues with the testing and treatment for Lyme disease. The different types of blood tests performed to identify Lyme disease often yield inaccurate results. This may mean that patients who in fact have Lyme disease are not diagnosed, or even more worrying, are misdiagnosed with multiple sclerosis or chronic fatigue syndrome and do not receive the appropriate treatment, exacerbating their symptoms. Some patients even have to travel to other countries to receive treatment, because it is inadequate in Canada.
The NDP believes that this bill would improve the treatment and outcome for Lyme disease sufferers. Canadians need a national strategy on Lyme disease to ensure that the testing and treatment options in Canada are improved. Therefore, we support this bill and believe it lays out a concise plan for educating Canadians about the disease and, more importantly, providing a better quality of life for Lyme disease sufferers.
To provide a bit of background on it, this disease is spread by tick bites. Ticks are small parasites that feed on the blood of animals and humans. They pass on Lyme disease when they feed on mice, squirrels, birds, or other animals who carry the bacterium and then bite humans.
Ticks are most common during the warmer months, from spring through to late autumn. Canadians who live in areas that have mild winter temperatures and minimal snowfall have an increased risk of coming into contact with ticks, which is a description of the climate on Vancouver Island. Climate change is one of the factors causing more regions to be at risk, with warmer weather increasing tick distribution across many parts of Canada.
I have been working on this file for a number of years. Back in 2010, I had written a letter to the then minister. We had a back and forth with a number of letters. I had written a follow-up letter asking for further clarification and action because part of the response from the government was that treatment and diagnosis is a provincial responsibility so there is really not much role for the government. I was trying to argue that of course there is a role for the federal government, and part of that role is around leadership. However, I reminded the minister that the federal government has a clear role to play in establishing the guidelines and that it is within this area that most action needs be taken.
I went on to remind the minister that the Canada Health Act's principle of reasonable access to health services without financial or other barriers is an important aspect of what Canadians expect in our publicly funded, publicly delivered health care system and that when we were seeing unequal access or seeing Canadians have to go out of the country in order to get adequate testing, that is absolutely a financial barrier.
I went on in the letter to say:
A number of studies have concluded that the tick vector is spreading rapidly in Canada, a process likely to be accelerated by climate change. Without current, up-to-date information about the geographical distribution of tick vector populations, doctors may falsely discount a possible Lyme disease diagnosis, and thus deny serological testing. In addition, the tick vector is also carried by migratory birds, and is therefore not isolated to any geographical region.
I quoted from an article published in the Canadian Medical Association Journal in 2009, entitled, “The emergence of Lyme disease in Canada”, stating:
...“effective enhanced surveillance involving federal and provincial agencies needs to be instigated and that clinician awareness of Lyme disease will be crucial in minimizing its impact”…as it is an emerging disease in Canada.
Further on I state:
Ultimately, Canadians are receiving inadequate care or no care at all when it comes to Lyme disease, forcing them to leave the country to seek medical attention. This is a direct denial of their rights. New national guidelines must be put in place to address this serious contravention of the Canada Health Act. Canadians should have confidence in their health care system.
Based on recent studies, the current Guidelines simply do not take into account that Lyme disease is emerging in Canada and that geography cannot be relied upon to diagnose Lyme disease. In addition, the two-tiered testing is fundamentally problematic as it excludes many patients who have Lyme disease from the more sensitive...testing...
In the response from the minister of September 15, 2011, it was interesting that the she indicated this in the letter:
Climate change is anticipated to accelerate the emergence of Lyme disease in Canada. Endemic Lyme disease risk occurs in much of southern British Columbia, but the vector here is less efficient, and risk is relatively low.
Therefore, even a couple of years ago the minister is indicating at that point that the risk was relatively low. I would argue that, because the government was not doing the kind of surveillance and follow-up that was required in order to determine the real incidence, people were simply being excluded.
There have been some changes. Although the government has moved to look at making this a nationally reportable disease in Canada, many people simply do not trust those numbers. Therefore, I will certainly be supporting Bill C-442. I want to commend the member for Saanich—Gulf Islands for bringing this matter forward. It is a very important matter for us in Nanaimo—Cowichan and the rest of Canada. I would encourage all members of this House to support this bill and let us get on with developing that national strategy that is so important for our constituents.