Dr. John Lambert:

On over-diagnosis, an antibody test shows that a person has the infection or had it in the past. If somebody such as a farmer from Malin Head is sick with a multi-system disease and the test result is positive, it is probably Lyme disease. What is needed is not an antibody test but a clinical diagnosis. Antibody tests are poor. It does not matter whether it is a German or an Irish test and the result is positive or negative, it could mean an infection or a prior infection. We need to educate people in how to take a good history, examine a patient and interpret test results. That is really important and the first issue.

There are more than ten or 100 patients with Lyme disease. We are underestimating the number of tick-borne infections. Vets treat thousands of animals with these infections all over Ireland and the world. It is clear that humans are being bitten by the same ticks and contracting the same diseases.

The next question was about following international best practice in guidelines. In France there is a pioneer by the name of Dr. Christian Perronne. He is one doctor who went against the Infectious Diseases Society of America, IDSA, and all of its clinicians. He has fought for five years and, against the wishes of many of his clinician friends, he has got the Irish Government to agree to the French plan. I refer to establishing treatment centres, using a clinical diagnosis and treating patients based on the response to therapy. We have a national outpatient antibiotic programme. We treat people with antibiotics, sometimes for two weeks, sometimes for four weeks, eight weeks and, in some cases, six months. The people who are probably coming here after this do this all of the time. We do not treat different infectious diseases for one time-set. Being prescriptive is not good for patients. The French guidelines recommend that we treat patients for as long as it takes to make them better. That is probably the best standard. There is a French national website which was put together by Dr. Perronne.

On how much people have to pay if they travel outside the country, sometimes the cost is €1,000 or €2,000 just for testing. If a person then travels to Germany or America, he or she will pay between €5,000 and €10,000 for short-term therapy. People will actually spend €30,000. I know people who have spent between €80,000 and €100,000. I refer to the former Kerry football player Anthony Morris who went to the Jemsek Speciality Clinic in Washington D.C. where, apparently, he paid $90,000. People are paying huge amounts of money for treatments, some of which are unnecessary. There is not always good science behind some of treatments available internationally. However, people are getting better-----