What the tick identification form is for
The form goes with a tick sent to Public Health Ontario for species identification. Ontario runs voluntary passive surveillance on ticks removed from people, and the data show which areas have rising numbers of certain species, including the blacklegged tick that carries Lyme disease. PHO notes that the information is used for public health surveillance.
PHO states that identification isn’t indicated for clinical management, and that, per Infectious Diseases Society of America guidance, tick testing shouldn’t be used to diagnose or manage Lyme disease. Lice, fleas, mites and maggots go on the General Test Requisition instead.
Who completes it
A health care provider or public health unit completes and submits it. The submitter section takes your name or clinic, and the clinician’s name with OHIP or CPSO number. Most of the tick information comes from the patient: where they were, whether they travelled, and when they found the tick. Ask those questions during the visit, since the two location fields are mandatory.
How to fill in the form
Submitter and Client Information
Give your clinic details, telephone and fax, and the patient’s name, date of birth, sex, address and phone. The patient’s name must match exactly on the form and the container label, or PHO won’t identify the tick. If a health unit gave an investigation number, add it.
Tick Information: where it was acquired and travel
Field a) asks where the tick was most likely acquired, as specifically as possible: province, town or park. Field b) asks whether the patient travelled in the previous two weeks, and if so, every place they visited. PHO marks both as mandatory, and missing answers can mean delay or rejection.
Tick Information: collection and attachment
Record when the tick was removed, whether it was attached and feeding, and for how long, in hours or days. Attachment time is the detail patients find hardest to estimate, so record what they tell you, even as a range.
Common reasons it’s rejected or delayed
- A missing answer to where the tick was acquired, or to the travel question.
- A patient name that doesn’t match exactly between the form and the container.
- A tick from a pet, another animal, or the environment.
- A tick submitted by someone who isn’t an authorized health care provider or health unit.
- A tick sent in a bag or envelope instead of a sealed container.
Submitting and who pays
Put the tick in a sterile, leak-proof plastic container. PHO allows a small amount of sterile saline or 70 to 100% ethanol to stop it drying out. Use one container and one form per patient, seal it in a biohazard bag, and send it to PHO’s laboratory at room temperature or frozen. Results go to the submitter, and PHO doesn’t give results directly to the public, so patients who want to know the species ask you.