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Irwin Cotler, MP



Debate on Bill C-442: National Lyme Disease Strategy

Posted on April 30, 2014

Hon. Irwin Cotler (Mount Royal, Lib.):

Mr. Speaker, I am pleased to rise to join in the debate on Bill C-442, an act respecting a national Lyme disease strategy. I commend my friend, the hon. member for Saanich—Gulf Islands for bringing forward this important bill that proposes the development of a national strategy in response to a growing issue of national concern.

I cannot overly stress how important this debate is, as well as its personal significance for me. As some members of this place may recall, a few years ago my daughter became ill. She had unexplained pains and symptoms of the kind and character that have been described by other members in the House in this debate that led her from doctor to doctor and diagnosis to diagnosis without any relief in sight.

It was a stressful and traumatic time for our entire family, a period and sense of both hopelessness and helplessness. Hopelessness on the one hand because it was unclear what the correct diagnosis was in the place of competing diagnoses, or the absence of any diagnosis at all, and helplessness because it was difficult to watch my daughter struggle and not be able to help in any way.

As is too often the case, one only learns the intricacies of a disease when one is confronted with it. That was my experience with Lyme. When my daughter’s purported diagnosis came I read as much as I could about the disease and was shocked at the Canadian experience with the disease when compared to the American one. Indeed, at the time I learned that there was already a U.S. Congressional caucus discussing this issue, and that there had already been proposed legislation introduced south of the border, while the debate had hardly begun in this House at all.

While many statistics have been quoted in the debate here, I would like to take a slight step back to note how Canada has been behind when it comes to Lyme disease. Here, I refer everyone to a response tabled by the government on November 15, 2011, in response to an order paper question from my colleague and friend, the member of Parliament for Etobicoke North. In that answer the government said:

The percentage of Lyme disease cases thought to be reported is unknown at present as Lyme disease has only recently become reportable.

Recall that was in 2011. Now less than three years later we know the reported cases of Lyme in Canada jumped 146% between 2009 and 2012. According to the Public Health Agency of Canada, 315 cases of Lyme disease were reported in 2012. According to CanLyme President Jim Wilson, the actual number is likely to be in the thousands given the massive under-diagnosis and under-reporting of the disease. The first reported case of Lyme disease in Quebec was in 2004. It was not until 2008 that the first case was confirmed inside the province.

Referred to as the “great imitator”, Lyme poses great difficulties for medical practitioners because it presents symptoms that are quite nebulous. Indeed, symptoms include joint pain, headache, and fatigue and these can easily be mistaken, and often are, for other illnesses.

Moreover, tick bites often go unnoticed and it is therefore difficult for doctors to recognize early stage Lyme based on initial symptoms that are generally associated with more benign conditions like the flu. It can also be very difficult to diagnose Lyme in children, who may not notice or communicate that they have been bitten by a tick. Indeed, in one recent study published by the journal Arthritis & Rheumatology, the first such study to identify the effects of untreated Lyme infection in children, researchers found that 76% of patients did not recall even having a tick bite.

If diagnosed early and treated with antibiotics within the first six weeks of an infection, the chances are high that a Lyme disease patient can achieve a full recovery. However, if left undiagnosed, the disease can quickly escalate: patients can develop a variety of neurological symptoms and are much more likely to develop debilitating and chronic conditions including arthritis and even facial paralysis. Currently, researchers at a new Lyme disease research facility, funded in part by the non-profit organization CanLyme, are preparing to use genetic testing to determine the extent to which some chronic diseases such as multiple sclerosis, fibromyalgia, and Alzheimer’s may in fact be the result of Lyme or other tick-borne infections.

It is clear that my background is not in medicine. Yet I understand as others in the House have said that much research remains to be done and the medical community itself is engaged in a debate over Lyme disease and its impacts over the long term.

This is in part what makes the bill so important. It allows medical professionals to share with each other and with policy-makers across the country at the federal, provincial, and territorial levels their evidence and best practices in order to facilitate a standardized approach to diagnosing and treating this disease.

In particular, the bill would require the Minister of Health to convene a conference bringing together his or her counterparts, representatives of the medical community, patients’ groups, and other stakeholders to discuss this important issue. Through collaboration with the provinces and territories and medical professionals, this bill would result in the development of a national strategy to address the challenges posed by the growing risk of exposure to Lyme disease in Canada. As has been acknowledged during previous debate on this bill, Lyme disease poses a major health problem about which Canadians are not sufficiently aware and for which we remain still ill-prepared.

Other members in this place have acknowledged the laudable intent of this bill, which the member for Saanich—Gulf Islands detailed in her remarks and has spoken to as eloquently as one could. As she explained, this is a bill that would deal with the threat of Lyme disease by creating a national surveillance system to address the problems of under-reporting and misdiagnosis, which we know can have severe consequences. It would also strive to achieve the sharing of best practices by medical professionals and ministers of health in the provinces and territories.

Before I close, I would like to draw attention to one other aspect of this national health crisis, which is the extent to which communicable diseases are inextricably intertwined with our natural environment. The recent explosion of the incidence of Lyme disease is tied to changes in climate and land use that can be difficult to track and may be overlooked by both medical practitioners and policy-makers. Indeed, the recent report by the Intergovernmental Panel on Climate Change specifically noted:

Substantial warming in higher-latitude regions will open up new terrain for some infectious diseases that are limited at present by low temperature boundaries, as already evidenced by the northward extensions in Canada…of tick populations…the vectors for Lyme disease…

Indeed, there are myriad unforseeable ways that climate change and other environmental concerns may affect public health. While this example is apparent now, there will be other such occurrences and we need to make sure that we take a holistic approach to understanding and responding to these types of threats.

Public health concerns of this kind, which require collaboration and education to achieve prevention, are perfectly suited for a co-ordinated federal framework to achieve, as the bill before us expressly sets out, increased public awareness, consensus for best practices, and an up-to-date understanding of emerging evidence regarding how this disease operates.

I trust that the members in this place will join in supporting this initiative by voting for this bill, thereby sending a clear message to Canadians that we are listening to their concerns, we are seeking to do what we can, and that we will act.

In closing, may I add that the member for Saanich—Gulf Islands‘ initiative in this regard is already having a positive influence. Indeed, just by debating this bill in a multipartisan matter, we are raising awareness and signalling to Canadians that this is a public health issue of national concern that deserves urgent attention and action.

I further trust that we will all join in supporting this bill so that we can take action to find the necessary solutions for the suffering of thousands of Canadians. It is a sad reality, as I indicated at the outset, that Lyme disease remains massively under-diagnosed and largely misunderstood, with the U.S. and Canadian experience differing in this regard. Cases have been skyrocketing along the U.S. side of the Vermont, New York, and Maine border with Quebec, though it should be clear that ticks do not stop at the border, as it has been said in this debate. Indeed, the prevalence of disease-carrying ticks in Canada has increased tenfold over the past two decades and there is just cause for great concern.

I am hopeful that in working together to address the situation, and with excellent bills like this going in the right direction, we will succeed in a common cause. May I conclude, again, by thanking the leader of the Green Party for this important initiative. I join again with all members in this place in expressing our sympathy and solidarity with those suffering from Lyme disease, as well as our support and appreciation to the doctors, nurses, and researchers seeking to combat Lyme disease and treat those afflicted with it.