Lyme Disease Halifax

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Browsing Posts tagged Janet Sperling

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November 28th, 2012
Dear Nova Scotia MLA/MP:
RE: Lyme Disease in Nova Scotia
Lyme Disease (LD) is an emerging disease in Nova Scotia and Canada that is generating considerable attention from the media, advocacy groups and communities. Given this situation, I felt it important that you had accurate and up-to-date information on LD in Nova Scotia and the provincial response plan.
LD is a bacterial illness that can be transmitted to humans through the bite of a blacklegged tick (deer tick). There are a number of tick species in Nova Scotia, but only the blacklegged tick can carry the bacteria that can cause LD. Not all blacklegged ticks carry the bacteria and the risk of acquiring LD remains low in the province. LD is readily treatable with appropriate antibiotics.
The Department of Health and Wellness (DHW) has an active LD response plan which includes an interdisciplinary committee (public health, veterinary medicine, wildlife biology) that provides evidence-based advice and guidance to the provincial government on the control of LD. Nova Scotia has multiple infectious disease and medical microbiologist experts in the province who deal with treatment and diagnosis of LD. DHW has a close working relationship with these clinical experts through an Infectious Disease Expert Group, which meets regularly to advise DHW on public health and infection control issues. We also work closely with our partners at the Public Health Agency of Canada and the National Microbiology Laboratory who provide evidence based recommendations for the prevention and surveillance of LD and ticks.
Tick and Lyme Disease Surveillance
Lyme disease is a notifiable disease under the National Microbiology Laboratory. Health care professionals are required to report cases of Lyme disease to Public Health when they diagnose clients clinically or with laboratory confirmation. In 2011, there were 54 confirmed cases of LD reported to Public Health, corresponding to an incidence rate of 5.8 cases per 100,000 population. Surveillance of both human cases and blacklegged ticks in the province enables DHW to keep abreast of the current state of Lyme disease in Nova Scotia.
Over the past few years, DHW together with the Department of Natural Resources and the Public Health Agency of Canada have been identifying and testing ticks collected in Nova Scotia. Analysis of this data has identified six areas where blacklegged ticks carrying the bacteria that can cause LD are known to be endemic (i.e. have become established as part of the local ecology). These endemic locations are areas in Yarmouth County, Shelburne County, Lunenburg County, Halifax County, Pictou County and most recently Queens County. These known endemic areas can be found on the Department of Health and Wellness website at http://www.gov.ns.ca/hpp/cdpc/lyme.asp
DHW has had a tick surveillance program in place since 2002, which included both passive (ticks being submitted by the public) and active plans. In the fall of 2011, DHW restructured its tick surveillance program to place an emphasis on active surveillance. Active surveillance involves ‘in the field’ work including small mammal testing and dragging vegetation to collect
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ticks. We will continue with focused active surveillance to determine additional areas where ticks may be establishing.
It is expected the number of LD cases will increase over time as ticks become more densely populated and expand their geographical range when conditions permit. Climate change related to global warming is expected to contribute to the increase of LD in Nova Scotia and Canada.
Public Information
DHW regularly provides consistent, evidence based information about LD and its prevention to the public. Strategies are implemented each year to provide Nova Scotians with information about the prevention of tick bites and to ensure health care providers have the most up to date clinical information. The DHW website is regularly updated plus we work closely with partners to disseminate information regarding LD to the public and stakeholders via various methods (letters via schools, residential letters, media releases, websites, signs in parks/campgrounds). DHW has also provided an advertorial for newspapers as well as news release each year. DHW regularly responds to multiple media requests and letters to government regarding LD.
Nova Scotians and visitors to the province can help prevent exposure to blacklegged ticks and LD by taking some simple precautions. This is especially important when in areas where there may be increased risk. Prevention messages can be found on the DHW website at: http://www.gov.ns.ca/hpp/cdpc/lyme.asp
Information to Clinicians
Webinars have been provided to health care providers in the last few years, addressing prevention, surveillance, diagnosis and treatment of LD. In addition, the DHW provides updates to physicians in the province via Doctors Nova Scotia. The Infectious Disease Expert Group has developed a document entitled “Statement for Managing Lyme Disease in Nova Scotia” which has been widely circulated to physicians in the province. This document is based on current evidence and follows the guidelines endorsed by the Infectious Disease Society of America.
Testing
Laboratory testing for LD in Nova Scotia follows the guidelines established by the Public Health Agency of Canada and the Centre for Disease Control and Prevention in the United States. These guidelines have been endorsed by the Canadian Public Health Laboratories Network and the Infectious Diseases Society of America.
We are aware of the Canadian Lyme disease advocacy group, Can Lyme, who claim that the testing and treatment of LD is inadequate. However, the testing methods they promote, and the ones used by many private labs in the US, are not endorsed by infectious disease and laboratory experts.
Research
DHW supports and partners with many researchers in the field of LD and tick surveillance. Research that DHW is aware of and supports includes the Public Health Agency of Canada’s study on identification of emerging endemic areas for the blacklegged tick and prediction of the further spread of LD. Two other research initiatives that DHW supports include the human seroprevalence study on LD and the Deer Treatment Study. We are aware that other
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researchers initiate studies within the province with or without consultation or consideration of experts on the interdisciplinary committee.
If you have additional questions regarding LD, or if you would like to involve a regional Medical Officer of Health in any meetings with community or advocacy groups, please contact your local Public Health office which can be found through the following website: http://novascotia.ca/DHW/about/phs-offices.asp
We appreciate your ongoing support and cooperation to help ensure Nova Scotians receive evidence-based information on LD.
Sincerely,
Robert Strang MD, MHSc., FRCPC
Chief Medical Officer of Health
c. Dr. Frank Atherton – Deputy Chief Medical Officer of Health, Health and Wellness
Elaine Holmes, Director – Communicable Disease Prevention and Control, Health and Wellness
Regional Medical Officers of Health

On December 12/2012 Canlyme printed this story …
http://canlyme.com/2012/12/12/misinformation-sent-to-all-nova-scotia-mlas-and-mps-by-chief-medical-officer-of-nova-scotia-robert-strang/ regarding a letter that was sent out to ALL MP/MLA’s regarding Lyme disease in Nova Scotia .  It seems I am not the only one upset about this letter.  One of the lines I was most upset with, because it rang so true, was not in the original “Strang Letter” , it was in the rebuttal from The Canlyme website…..
“Canadian Infectious Disease doctors Canada wide have refused in writing to see any patient that did not pass that flawed protocol “.
That sentence directly applied to me, as I too could not be seen here in Nova Scotia by Infectious disease, and I also know of others. I also have it in writing,  not once, but twice  !!!!!  I decided to enquire about the contents of the letter (which would be used to educate the public and squash public fear) but it was more like pulling teeth.  I emailed all 52 constituents to see what they thought. The responses were varied, to say the least. What I received was anything from no to yes, through a third party,  to pretty much ….. you may as well take a hike.  It will take awhile to get these posted…. but here’s a small taste.
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MLA for Lunenburg West (endemic jurisdiction Lunenburg and Queens Co.)

He is Ministerial Assistant to the Department of Health and Wellness.

From: ns_hottie@hotmail.com
To: gary.ramey.mla@eastlink.ca
Subject: Re: Lyme disease in Nova Scotia
Date: Mon, 17 Dec 2012 23:57:25 -0300
Dec 17, 2012
This note is in regard to Dr. Strang /Chief Medical Office (DHW) letter regarding Lyme disease. This letter was sent out to all MLA/MP dated November 28, 2012 . Could you please confirm that your office has received this letter from him.
Thank you in advance,
Ingrid
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From: ingrid
Sent: Wednesday, December 19, 2012 10:35 AM
To: gary.ramey.mla@eastlink.ca
Dear Constituent,
I sent you an email two days ago and have not had a response yet. Do you have someone that answers emails from the people that elected you?  As an elected member I would expect at least that. The only question I had, at that time, was if you received the letter from Dr. Strang/Chief Medical Officer of Health regarding Lyme disease?  Lyme disease is a province wide issue. However, now I am very dismayed that I have not received any response …..PLEASE RESPOND!!
Sincerely Ingrid
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From: gary.ramey.mla@eastlink.ca
To: ns_hottie@hotmail.com
Subject: Re:
Date: Wed, 19 Dec 2012 14:35:54 -0400
Dear Mrs XXXXXX :
I apologize for not responding sooner as I thought this was a hoax. Let me explain why.  It is addressed to Dear Constituent. I am the MLA for Lunenburg West, although technically I suppose I am  my own constituent. I have no idea if you are even a constituent of mine as you have not identified your home community, and I respond, as much as possible, to my own constituents first.   I get many e-mails per day along with many phone calls.  I try to respond to everyone as soon as possible , but events at this time of year often take me out of the office, and I am a bit slower at getting back  As I indicated, I thought the bizarre salutation made this a hoax.  I answer all my own e-mails, as I am the elected representative, and as such I am the one who should and does respond.  I am not sure why a two day response window would cause you to  be dismayed, but in answer to your question, I did receive a letter from Dr. Strang, and I have referred your inquiry to his office
Best Wishes for a Happy Holiday Season.
Gary
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From: ingrid
Sent: Tuesday, January 01, 2013 3:26 PM
To: gary.ramey.mla@eastlink.ca
Subject: FW: LYME DISEASE/HOAX/STRANG LETTER
constituent – a member of a constituency; a citizen who is represented in a government by officials for whom he or she votes; “needs continued support by constituents to be re-elected”

Attention: RE: LYME DISEASE/HOAX/STRANG LETTER
Tuesday Janruary 01, 2013
Dear Mr. Gary Ramey MLA Lunenburg West,
HOAX ????
WOW… JUST WOW !!!!
Thankyou very much for your note and addressing my inappropriate verbatim and usage of the word ” constitiuent”. It absolutly astounds me that someone with part of your Bio. Premier Darryl Dexter’s Ministerial Assistant for the Department of Health and a former board memeber of Bonnie Lea farm (so eleqauntly-I might add) took a full paragraph to address. Were you trying to be rude, belittling or were you just trying to avoid this issue of Lyme disease and the “letter” all together?
While I do not live in “YOUR” endemic area, Lyme disease is a serious Province wide issue!!!!
As being our Premier’s Ministerial Assistant I would assume that you would have been one of the first to have been privy to the letter “Lyme disease in Nova Scotia” by our Chief Medical Officer-Dr. Robert Strang, before it was sent out. I’m perplexed as to why you felt the need to address the “bizzare” salutation in great detail, rather than the important issue at hand. Why did you forward my inquiry to Dr. Strang’s office? Our Premier has first hand knowledge of the issues with Lyme disease in this province, have you spoke to him regarding Lyme disease? My question was to you Mr. Ramey, more importantly, what did you think of the letter?
Sincerely,
Ingrid
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From: gary.ramey.mla@eastlink.ca
To: ns_hottie@hotmail.com
Subject: Re:
Date: Wed, 19 Dec 2012 14:35:54 -0400
Thank-you for your email.  I want you to know that my response to you was in no way meant to be condescending, belittling, or rude.  It is not in my nature to treat others this way, and conversely I do not enjoy being treated that way myself.  I reiterate that I thought because of the salutation that this e-mail was a hoax.  I also recollect there was something about the return e-mail address that I found strange, but I would have to go back and look at the original e-mail to check on what that was.
In any event, my role as Ministerial Assistant does not make me privy to discussions on health care policy in Nova Scotia on a regular basis, nor, in my role as Ministerial Assistant, am I consistently informed on all the issues that are the purview of the Department of Health and Wellness.  Policy discussions and health care practices are in the arena of the minister in consultation with experts in their respective fields, of which Dr. Strang would be one. In 2009, when our government was elected, we merged the Department of Health and the Department of Wellness together to form one.  As a result, the minister’s role was expanded due to the formation of of one ministry from two.  The role of the Ministerial Assistant is similar to that of a Parliamentary Secretary to a federal cabinet minister.  This means I often appear on behalf of the minister at an event, or deliver a speech on his behalf.  My role is not to formulate policy, or to be consulted or briefed on the myriad of health-related issues confronting the minister.  That’s his defined role.
I recognize that Lyme Disease is a health issue in our province and, specifically in my area of the province,—–  Lunenburg and Queens Counties. I read the letter from Dr. Strang and felt it was thoughtful, comprehensive, and clear.  I know this issue continues to receive attention at the department.  Not being an expert in this field, nor having a role to play that would be applicable, I forwarded your concerns to the individuals in government who would be most likely to professionally address this issue.  It is my duty to do this, as that is my role as an MLA.
I hope this clarifies my position on this matter.
Happy New Year
Warmest regards,
Gary
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From: Lyme Ing <onesicklymie.realitycheck4u@yahoo.com>
To: “gary.ramey.mla@eastlink.ca” <gary.ramey.mla@eastlink.ca>
Sent: Tuesday, January 15, 2013 10:40 PM
Subject: LYME DISEASE IN NOVA SCOTIA
RE: LYME DISEASE IN NOVA SCOTIA
Dear Mr. Gary Ramey MLA Lunenburg West:
Thank-you very much for your email. The orignal intention of this email was to find out if you as an “MLA” had received the letter “Lyme disease in Nova Scotia” by Dr. Strang/Chief Medical Officer of Health dated November 28/2012 and WHEN ? It seems that as of today’s date not all MP/MLA’s have received it (some have received it through a third party). When did you recieve this letter directly from Dr. Strang’s office is the question? Please do not forward this question to Dr. Strang’s office (I have his email) as this question was not posed to him it was directed at you soley as your role as an MLA with Lunenburg being an endemic area, which is in your arena as an MLA.
Please note:
I have changed my email address from  ns_hottie@hotmail.com (the email address you found strange)  to  onesicklymie.realitycheck4U@yahoo.com maybe we can stay focused on the task at hand , and not skirt the issue.
Happy New Year,
Sincerely,
Ingrid
**** Still awaiting response…!!! ****
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Dartmouth East-Andrew Younger MLA

From: ns_hottie@hotmail.com
Subject: RE: Lyme disease in Nova Scotia
Date: Tue, 18 Dec 2012 00:05:22 -0300
Dec 17, 2012
This note is in regard to Dr. Strang /Chief Medical Office (DHW) letter regarding Lyme disease. This letter was sent out to all MLA/MP dated November 28, 2012 . Could you please confirm that your office has received this letter from him.
Thank you in advance,
Ingrid
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From: ingrid (ns_hottie@hotmail.com]
Sent: December-18-12 1:29 PM
To: Office of Andrew Younger MLA
Subject: RE: Lyme disease in Nova Scotia
Do you have someone that responds to emails?
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From: info@andrewyounger.ca
To: ns_hottie@hotmail.com
Subject: RE: Lyme disease in Nova Scotia
Date: Tue, 18 Dec 2012 18:43:17 +0000
Yes Ms. XXXXXX, I respond to emails on behalf of Andrew’s office.
However, I wanted to check with Andrew about a response to your query.
This constituency office has never received any missive from Dr. Strang regarding Lyme disease, nor any other topic in recent memory. Neither has Andrew’s Liberal Party office (the caucus office) in downtown Halifax.
At this point in time, we have yet to find an MLA who is in receipt of this message from Dr. Strang regarding Lyme disease.
What we have received, is an email “in response to” Dr. Strang’s mystery message stating that Dr. Strang’s letter contains “some serious misinformation”. That email has been forwarded to Andrew, via this office.
We hope that answers your question.
Regards,
Patti Tabor
_______________________________________
Patti Tabor | Constituency Assistant
Office of Andrew Younger
MLA – Dartmouth East
73 Tacoma Drive, Suite 600 |
Dartmouth | Nova Scotia | B2W 3Y6
T: 902.406.4420 | F: 902.406.4421 | E: info@andrewyounger.ca
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Vicki Conrad MLA Queens

Ingrid, on behalf of Vicki Conrad, thank you for your email and my apologies for not responding earlier.  We have received the letter from Dr. Strang and we have been advised that Dr. Strang will be addressed the inquiry in the new year.
Seasons’s Greetings & Happy New Year!
Judi Milne, Constituency Assistant
We Build Ships – check it out: www.shipsstarthere.ca
VICKI CONRAD, MLA Queens
Ministerial Assistant to Transportation & Infrastructure & Caucus Chair
PO Box 430, 43 Carten St., Liverpool, NS  B0T 1K0
902-354-5203, fax 1-902-354-5247, toll free 1-888-354-5203
www.vickiconrad.ca
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As a footnote (from Canlyme) :

Local MLAs hear requests for Lyme disease vigilance

NEW GLASGOW – Pictou County’s three MLAs and several county councilors got educated about Lyme disease from those suffering from the disease. They also received a long list of items the delegation wants instituted into Nova Scotia’s detection and treatment of the disease during a meeting on Monday at Justice Minister Ross Landry’s Pictou Centre constituency office. “We did our best,” delegation member Alice Lees said. “There are strong intentions and they’ve information that will be helpful.” Besides Landry, Energy and Natural Resources Minister Charlie Parker and Pictou East MLA Clarrie MacKinnon, municipal councilors in attendance included Deputy Warden Andy Thompson, Sally Fraser, Debi Wadden and Jamie Davidson. “We know Lyme disease is a serious and real problem,” Landry said. “The big thing is getting the medical and health communities and the public educated. We met to help assure that various departments are aware of this.” The delegation members want the Medical Act of Nova Scotia updated to ensure those with Lyme disease receive the same guarantee former Health Minister Maureen MacDonald asserted “that all Nova Scotians receive the best possible care from highly qualified and trained doctors.”