Dr. John Lambert:

All I can tell Deputy Donnelly is that all the evidence that went to the WHO to review these chronic conditions and treatments for chronic infection have given rise to new ICD-11 codes. They were reviewed by worldwide experts.

Why does IDSA state there is no such thing as chronic Lyme disease? The last guidelines are from 2006 and they were reviewed by what was then the Institute of Medicine in 2011 in Washington DC. They were seen as not fit for purpose as they were not evidence-based. Those guidelines were removed from the website as a result. I do not know why many of my colleagues continue to say we use the 2006 guidelines as they are evidence-based and it is the current recommended treatment. There are new guidelines used by many clinicians treating these patients. This is a smaller group of 1,000 people in the International Lyme and Associated Diseases Society, ILADS, who are treating the disease. These 2014 guidelines are also evidence-based and it indicates longer courses of treatment. There are publications to support that.

There is a large polarity between IDSA and ILADS. I am a member of ILADS, IDSA and the Infectious Diseases Society of Ireland. Has any of my colleagues in Ireland ever spoken to me about this matter? It is like Chinese whispers. It is a bit of a puzzle to me as well. There are strong opinions in the medical community and held by specialists. Those can be written down but has there ever been an open forum discussing the science and looking at the new World Health Organization guidelines? Is any of the people coming today aware of the new WHO guidelines and the ICD-11 codes? I do not think they are.