Shane Ross (Independent)
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This matter concerns the need for the Minister for Health and Children to make Lyme disease a notifiable illness in Ireland, thus increasing the specialist medical help available to sufferers as well as publicising the risk from the disease. I raise this issue because one of my constituents has suffered from this disease over a long period of time. Her frustration has been painful, both mentally and in terms of the disease itself. Lyme disease is hardly above the radar in terms of medical recognition in Ireland. The idea is to ensure the Government recognises it as a notifiable disease, defined as any disease required by law to be reported to the Government authorities. The disease is widespread and can be caught in the hills of Wicklow or in South Africa. There is a misconception that one must go abroad to get Lyme disease but that is not true. One can get it from a tick bite that one can find in any country in the world. It is a serious disease in that no cure is known at the moment.

The problem is one of recognition and diagnosis. By making it a notifiable disease it will get that recognition and diagnosis. It is a bacterial infection and needs early diagnosis. It is difficult to diagnose the 300 symptoms that reveal the presence of this disease. Doctors have not recognised Lyme disease until now and have misdiagnosed it as something else. Many other diseases, including the common flu and Bell's palsy, have been mistaken for it. I would like the Minister to consider instructing the HSE to make it a notifiable disease because this is not a matter of getting treatment or monetary benefit for a patient but getting better monitoring of the disease. This is not a special pleading. The great advantage of making this a notifiable disease is that doctors will immediately know more about it and patient awareness will be greater. It will then be diagnosed more quickly. I cannot see any reason it has not then made notifiable by now but I can only imagine that we have not got around to it at this stage.

Patients who suffer from this in Ireland have tended to seek cures that are unnecessary. They tend to head overseas for medical treatment, which is very expensive, or they have gone for less orthodox cures that are not in their interests. The frustration of not finding out what is wrong and the unwillingness of doctors to admit that this is the case means the information flow is lacking in respect of the cure and the treatment.

A company called Trinity Biotech has produced a diagnosis screening process that allows the disease to be diagnosed and resolved. Although it is difficult to treat, if the Government recognised it, the solution could be used to make the suffering of these people much easier. I am not suggesting this is a cure but it will ease the pain of patients and the Minister can do this by providing notifiable disease categorisation which will put the information out in the open and make their lives easier.

Áine Brady (Kildare North, Fianna Fail)
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I will respond to this matter on behalf of my colleague, the Minister for Health and Children, Deputy Harney. I thank Senator Ross raising this matter as it provides me with an opportunity to outline to this House the importance attached to the issue by the Department of Health and Children and the HSE. Lyme disease, also known as Lyme borreliosis, is an infection caused by a spiral shaped bacterium called Borrelia burgdorferi that is transmitted to humans by bites from ticks infected with bacteria. The infection is generally mild affecting only the skin but can sometimes be more severe. Lyme disease has been reported in North America, Europe, Australia, China and Japan. The ticks feed by biting and attaching to the skin and sucking blood, normally from animals such as sheep and deer. Infected ticks are most likely to be encountered in heathland and lightly forested areas of North America and northern Europe. Lyme disease can affect anyone but is most common among ramblers, hill walkers, hikers, campers and others whose leisure activities and work takes place in heathland or light woodland areas or brings them in contact with certain animals such as deer. Summer and autumn is the period when most cases occur. Cases of Lyme disease appear in Ireland every year.

Although Lyme disease is not a notifiable disease in Ireland at present, it is recognised as an important vector borne disease. Like any disease, Lyme disease can present a very mild illness or, in a small percentage of cases, it can lead to fairly serious complications. As most people suffer only mild symptoms and recover without recourse to a general practitioner, making the disease notifiable would not detect these cases. In cases where the diagnosis is unsure, general practitioners and physicians have access to the National Virus Reference Laboratory which can diagnose the illness serologically by internationally accepted laboratory methods. In Ireland, surveys have indicated that the Cork and Galway regional clinical laboratory services receive about 500 requests for Lyme disease tests per year, of which 5% to 10% turn out to be positive. Many affected people have no symptoms at all. The most common noticeable evidence of infection is a rash called erythema migrans that is seen in about three quarters of infected people. This red, raised skin rash develops between three days and a month after a tick bite and spreads outwards from the initial bite site. This rash can last up to a month and be several inches in diameter. People can also complain of flu-like symptoms such as headaches, 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 amoxicillin are effective in clearing the rash and helping to prevent the development of complications. Currently, there is no vaccine available in Ireland against human Lyme disease.

A number of awareness initiatives have been undertaken by the Department and the HSE to address the threat of Lyme disease in Ireland. In terms of public awareness, information has been placed on the website of the HSE health protection surveillance centre and leaflets designed for distribution at the reception areas of Ireland's national parks by forestry staff of the Department of the Environment, Heritage and Local Government have been distributed and are available for download from www.hpsc.ie. In addition, as the best protection against Lyme disease is to protect oneself against tick bites when walking in grassy, bushy or woodland areas, the health protection surveillance centre has produced information and guidance on its website to allow people to take steps to protect themselves and their families.

The issue of Lyme disease has been discussed and raised with fellow professionals through the health section surveillance centres vector borne sub-committee. This autumn, an article on Lyme disease is planned for the health protection surveillance centre's regular publication with the intention of raising awareness among general practitioners and non-specialist clinicians.

Shane Ross (Independent)
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Perhaps it is due to my complete ignorance but I do not know what vector borne means. I do not have a clue what that means so it would help if I could have an explanation for it. I do not accept the response of the Minister of State, which states: "As most people suffer only mild symptoms and recover without recourse to a general practitioner, making the disease notifiable would not detect these cases." I am not interested in the milder cases; it is a severe case we are discussing. The response suggests that most people get this mildly and only a few people get this badly. I want to know about the people who get this disease badly. Why should they be condemned to having it misdiagnosed or not diagnosed at all? These are the people to whom I refer. It is like many diseases which most people do not suffer from very badly. It is like swine flu and ME and many other illnesses. It is the people who suffer from it acutely who are important. To state most people contract it in mild form that we need not worry about the others is not enough. The reason for making it notifiable is to recognise those who suffer badly from it. Will the Minister of State tell me why they are not being considered and, of course, what "vectorborne" means?

Áine Brady (Kildare North, Fianna Fail)
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I did not state it would not be considered a notifiable disease. It appears that the main focus is on awareness. I did not state the Department was not considering making it a notifiable disease.

Shane Ross (Independent)
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Therefore, the Department is considering making it a notifiable disease.

Áine Brady (Kildare North, Fianna Fail)
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Nothing in the response states it is not considering making it a notifiable disease. However, the focus is on making people more aware of it.

Shane Ross (Independent)
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The point is that in making it a notifiable disease we would make people more aware of it. That is the point of the Adjournment motion.

Áine Brady (Kildare North, Fianna Fail)
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I take the Senator's point.

Shane Ross (Independent)
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Will the Minister of State tell me what "vectorborne" means?

Áine Brady (Kildare North, Fianna Fail)
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No, but I presume it has something to do with ticks because they feed on the blood of animals such as deer and live in heath or bushy or grassy woodland areas.

Shane Ross (Independent)
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On a point of order, I am not trying to be insulting to the Minister of State in any way but it is indicative of the way this House is sometimes treated that a Minister of State comes in with a script and does not know what the reply means. We should have the right Minister here.

Pat Moylan (Fianna Fail)
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The Minister of State will convey the Senator's concerns to the relevant Department

Shane Ross (Independent)
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Yes, but if we had the right Minister here, presumably he or she would know what "vectorborne" and the reply meant.

Áine Brady (Kildare North, Fianna Fail)
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I will send the meaning of the word to the Senator.