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Feb 2020

Early Lyme Disease


Lyme disease is already the most common tick-borne illness in Canada, and its incidence is increasing significantly as populations of blacklegged ticks continue to spread. With improved diagnosis and treatment of early localized Lyme disease, fewer patients will progress into later stages.

Early Lyme Disease Management in Primary Care Tool has been developed to help providers diagnose and treat early localized Lyme disease. A complementary patient resource provides information for patients who have been bitten by a tick or diagnosed with early Lyme disease.


About the tool

Blacklegged tick populations in Canada continue to spread, and the incidence of Lyme disease is increasing. As a result, primary care providers will be exposed to more patients who have been bitten by blacklegged ticks, and more who have contracted Lyme disease. Improvements in the diagnosis and management of Lyme disease are therefore necessary. This Tool addresses these changing needs.

Specifically, guidance is provided for the diagnosis and management of early localized Lyme disease. Topics addressed include:

  • Identification of erythema migrans (EM) rash
  • Options for managing patients in the absence of EM rash
  • Information on serologic testing
  • Appropriate antibiotic treatment
  • Advice for managing tick bites

In order to facilitate a partnership of understanding, a complementary patient-friendly handout has been developed that accurately explains concepts relating to early localized Lyme disease.

The Early Lyme Disease Management in Primary Care Tool was developed using the Centre for Effective Practice’s (CEP’s) integrated knowledge translation approach. This approach ensures that providers are engaged throughout the development processes through the application of user-centered design methodology. Clinical leadership of the resource was provided by Dr. Cecilia Newton, CCFP. End users, patient representatives and clinical experts were also engaged to provide feedback.

The Early Lyme Disease Management in Primary Care Tool has been funded by the Public Health Agency of Canada through the Infectious Disease and Climate Change Fund (IDCCF). This Tool was developed by the Centre for Effective Practice with support from the College of Family Physicians of Canada.

Clinical leads

  • Cecilia Newton


    Dr. Cecilia Newton is a family physician who practices at the Lunenburg Family Health Clinic and Fishermen's Memorial Hospital in Lunenburg, Nova Scotia, and is an assistant professor in the Department of Family Medicine at Dalhousie University. Dr. Newton has a Master's Degree in Neuroscience and Neuroanatomy. She completed her MD and residency in Family Medicine at Dalhousie University. She has a special interest in the diagnosis and management of early Lyme Disease since she lives and practices in an area with the highest incidence of the disease in Canada. She is also a member of the Canadian Lyme Disease Research Network, and is participating in a study that will establish a Lyme disease patient cohort and biobank in Lunenburg County.

Clinical Working Group

  • Todd Hatchette, MD, FRCPC
  • John Jenkins, MD, CCFP
  • Marnie LePage
  • Kieran Moore, MD, CCFP(EM), FCFP, MPH, DTM&H, FRCPC
  • Samir Patel, PhD, FCCM
  • Marg Sanborn, MD, CCFP, FCFP
  • Valerie Winberg, NP
  • Liz Zubek, MD, CCFP, FCFP

Thank you to all of our members for their work!

Expert Reviewers

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