Case Synopsis

The blacklegged tick population is increasing within the Realike region, and this has been associated with the emergence and increase of Lyme disease cases in the area. Zachary Smith, the Manager of the Safe Water and Rabies Prevention & Control, and Vector-Borne Disease team at the Realike Health Unit’s Environmental Health Department, has been notified by Public Health Ontario of a potential Lyme disease outbreak in the area. Lyme disease is a vector-borne disease caused by bites from blacklegged ticks, also known as deer ticks, that are infected with Borrelia burgdorferi bacteria. The disease was once mostly endemic to the United States, Europe, and parts of Asia. However, due to the uncertainty and negative impacts induced by climate change, the Realike region is now an endemic Lyme disease risk area. As per Ontario’s Emergency Management and Civil Protection Act, all municipalities should be prepared for emergencies such as disease outbreaks and, therefore should develop an emergency management program (Government of Ontario, 1990b). Further, the latest amendment of the Ontario Public Health Standards includes the addition of emergency management as one of the four foundational standards (MOHLTC, 2018a). This mandates that public health programs and services delivered by Ontario public health units incorporate all four of these foundational standards. The province’s public health standards state that emergency management plays a critical role in public health programming as it enables boards of health to ensure that they possess the capacity to respond to emerging and re-emerging threats within the community. Compliance with the standards also ensures that health units maintain adaptability and are resilient during times of high stress and in the presence of disruption. Currently, Ontario does not have any guidelines or emergency management plans for Lyme disease. Zachary must consider all elements of the problem and apply a systems-thinking approach to develop an efficient emergency preparedness plan for Lyme disease. This plan will provide a safe and healthy environment for the residents of the Realike region by ensuring that they are aware of the increased level of Lyme disease within the region.

Case Objectives

  1. Devise an emergency preparedness management strategy that can be applied in the event of a vector-borne disease outbreak.
  2. Understand the importance of standardized approaches yet recognize that there is no “one-size-fits-all” approach and that concepts must be applied to a specific situation.
  3. Identify how climate change may contribute to emerging public health concerns and impact vector-borne diseases such as Lyme disease.
  4. Understand the importance of adaptability and resilience in the decision-making for unpredictable and rapidly changing situations.
  5. Apply a systems-thinking approach to understanding the problem and to finding a solution

Case Study Questions

  1. Explain the importance of the four domains of the Public Health Preparedness and Response Competency Model and apply each of them to the case.
  2. List the five emergency management components and apply each one within the context of the case. Do they all apply to the case? Why or why not?
  3. What is an Incident Management System and what are its main benefits?
  4. In the context of this system, what are the roles that must be carried out during every incident? Describe each one in one sentence.
  5. According to the Emergency Management and Civil Protection Act, what are the main components of an emergency management program?


Climate change, decision-making, disaster response, emergency management, emergency preparedness, Incident Management System, leadership, risk assessment, risk management, vector-borne disease, stakeholder engagement, Lyme Disease, Ticks



Recommended Citation

Sheikh, R., Sekercioglu, F., & Speechley, M. (2020). Preparing for the Tickpocalypse in: McKinley, G. & Speechley, M. [eds] Western Public Health Casebook 2020. London, ON: Public Health Casebook Publishing.