New collective prescription
The Regional Director of Public Health for Montreal has issued a collective prescription that allows community pharmacists in Montreal to offer post-exposure prophylaxis (PEP) to anyone bitten by a tick possibly infected with Borrelia burgdorferi (the bacteria responsible for Lyme disease) in a geographic area with a significant risk (Estrie, Montérégie, Outaouais, Mauricie-et-Centre-du-Québec and some areas outside Quebec).
Until recently, collective prescriptions were only available to pharmacists in these regions for their territories. With a collective prescription for Montreal, the Direction régionale de santé publique de Montréal (DRSP) wants to meet pharmacists’ growing need to be able to offer PEP to anyone who has been exposed to Lyme disease in a geographic area where PEP is recommended. Although the at-risk areas for Lyme disease are all outside Montreal, Montrealers who visit these areas can still be exposed to tick bites. The collective prescription was also necessary given the rise in cases of Lyme disease in Quebec.
The PEP prescription is based on very strict criteria from a provincial medical protocol.
Pharmacists must analyze each case and ensure the following conditions are met
- The person is asymptomatic
- The bite is indeed a tick bite
- The bite occurred in a PEP-designated geographical area
- The time between the tick removal and the consultation is 72 hours or less
- The tick was attached to the skin for at least 24 hours
The best way to avoid getting Lyme disease is to avoid tick bites in the first place. People should prevent these bites during outdoor activities or any other activity in an environment where ticks may live.
If you think that you may have been bitten during an outdoor activity that exposed you to ticks, call Info-Santé at 811 for an evaluation and a referral to the best resource.
Note that cases in Quebec increased in 2019 (461 cases) compared to 2018 (304 cases). Most people contracted these infections in Quebec, particularly in the Eastern Townships and Montérégie. Montreal is not considered an endemic region, but the area is still at risk