Leo Varadkar (Dublin West, Fine Gael) | Oireachtas source

I thank Deputy Neville for raising this topic. Lyme disease, also known as Lyme borelliosis, is an infection caused by the bacterium Borrelia burgdorferi. It is transmitted to humans by bites from ticks infected with the bacterium.

Lyme borelliosis was made a statutorily notifiable disease in Ireland by the Infectious Diseases (Amendment Regulations) Regulations 2011. There were 20 cases of Lyme borelliosis notified in 2013 and 8 cases notified in 2012, the first year for which notification was compulsory. However, due to the diverse and unspecific nature of the symptoms a number of the less serious cases may not be diagnosed, leading to an under-reporting of cases. Recent estimates suggest that there may be up to 50 to 100 cases in Ireland per year. The increase in reported cases since 2012 is likely to reflect the fact that Lyme borelliosis is now a notifiable disease and hence there is increased public awareness of the condition, rather than an increase in incidence of the disease.

The infection is generally mild affecting only the skin, but can occasionally be more severe and highly debilitating. Many infected people have no symptoms at all. The commonest noticeable evidence of infection is a rash called erythema migrans, commonly called a bulls-eye rash, which is seen in 80-90% of patients. People can also complain of 'flu-like symptoms such as headache, sore throat, neck stiffness, fever, muscle aches and general fatigue.

Occasionally, there may be more serious symptoms involving the nervous system, joints, the heart or other tissues.

Common antibiotics, such as doxycycline or amoxicillin, are effective at clearing the rash and helping to prevent the development of complications. They are generally given for approximately three weeks. If complications develop, intravenous antibiotics may need to be used. Both the Health Protection Surveillance Centre, HPSC, and Tick Talk Ireland provide guidance on protection against contracting Lyme borelliosis.

The best protection is to prevent tick bites when walking in grassy, bushy or woodland areas, in particular between May and October. Arms and legs should be covered and wearing long trousers tucked into socks or boots and long-sleeved shirts with cuffs fastened is advised. Shoes or boots should be worn rather than open-toed sandals.

The use of insect repellent on clothes is recommended or on limbs, if it is not practicable to cover up. Skin and clothing should be inspected for ticks every three to four hours and children's skin and clothes checked frequently. Ticks should be removed as soon as they are seen attached to the skin. Further advice on tick removal can be obtained from the HPSC website. It is not recommended that antibiotics are given to prevent the transmission of Lyme disease following a tick bite. People should see their doctor if they develop a rash or become unwell with other symptoms, letting the doctor know of exposure to ticks.

There is an ongoing publicity campaign in regard to Lyme disease. The HPSC is finalising the establishment of a Lyme borelliosis sub-committee with the primary aim to examine best practice in prevention and surveillance of Lyme disease and to develop strategies to undertake primary prevention in order to minimise harm caused by Lyme borelliosis in Ireland. This will involve raising awareness among clinicians and the public. It will also explore ways to ensure that these messages are brought to the attention of the general public with the frequency and in forms in which they can be most effective. The sub-committee is expected to meet later this month.

Each year, as part of its ongoing awareness raising regarding prevention and treatment of Lyme disease, the HPSC holds a Lyme disease awareness week in which media releases are sent out with the intention that media outlets would take up the important Lyme prevention messages. As part of last year's awareness week, a supply of information was made available to the public and attention was drawn to a tick-borne disease toolkit, developed by the European Centre for Disease Control, ECDC. This toolkit was modified for use in Ireland and posted on the HPSC website. Indeed, the ECDC informed the HPSC that Ireland was the first European member state to make such extensive use of this material. Following the awareness week, a 100% increase of web traffic to the various Lyme disease sections of the HPSC website was noted.

I am pleased to inform the House that the number of notified cases of Lyme borelliosis will most probably be down on those for 2013. As I said, there were 20 cases notified for 2013 and while there are also 20 notified for 2014, it is expected that this figure will reduce on validation. Indeed, in the first seven weeks of 2015, two cases have been notified compared to four for the first seven weeks of 2014.

See this speech in context