Comment; Lyme is a very complex disease, difficult to diagnose & treat. Busy clinicians do not have time to spend hours poring over literature, we need accurate, unbiased information, non-controversial articles so we don’t waste our time. Better peer review would have helped.

In all, 53 troubling points were noted throughout the article, including invalid entry of tick data, omission of key ecological and epidemiological information, and misrepresentation of facts about ticks and climate change. The authors state that they want to mitigate the Lyme disease problem in the NWHU catchment area, but they offer no viable solution for this pernicious, zoonotic disease. Because the vast majority of health care practitioners are not recognizing Lyme disease and associated tick-borne zoonoses, the existing health care situation is not only untenable, it is outside the code of professional and medical ethics. There is a practical medical solution: Lyme-literate health care professionals are needed throughout the province of Ontario who have at least 30 ILADS-based CME credits in Lyme disease and associated tick-borne diseases, and can diagnose and treat suspect human cases efficaciously, as clinically required.