Nessa Cosgrove (Labour)
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I have just spotted Keith Henry in the Visitors Gallery. There might be a Ballymote bunch here.

Most people probably know that Lyme disease is a bacterial infection that is spread through the bite of an infected tick. This is a potentially serious illness, but it can be prevented through a number of precautions. When Lyme disease is contracted, it can be treated with antibiotics if it is diagnosed in time. If it is not diagnosed or not treated early enough, Lyme disease can have devastating consequences for those who contract it. Early symptoms include a bullseye-type rash around the site of the bite. It is not unusually sore or itchy, but it can increase in size. Other symptoms include flu-like symptoms, headaches, sore throats and stiffness. These can become more severe if symptoms persist. Due to the similarity of these symptoms with other illnesses, Lyme disease is not always easy to diagnose and is often referred to as the great imitator. If it is left unrecognised and untreated, Lyme disease can cause harrowing severe illness and complications, including persistent fatigue, chronic pain, depression and cardiac and neurological symptoms. Fiona Quilter is a woman from Sligo whose health has been ruined, and that is not an understatement, by chronic Lyme disease. She has taken the step of going public along with many of her fellow sufferers of Lyme disease. A very informative cross-party Oireachtas group has been set up. She has highlighted the possible consequences of Lyme disease and the failure of doctors to recognise and treat it. Fiona's condition has been diagnosed as fibromyalgia, chronic fatigue syndrome, thyroid disease and functional neurological disorder. Delays in recognition and diagnosis allow the disease to get a firmer grip on a sufferer's system and mean the single two-week course of antibiotics available under the HSE becomes less likely to work. This leads to further complications and to people having to seek treatment abroad in Germany. Fiona has had to retire from work. She has had to sell her house to fund her treatment. She has estimated that to date she has spent approximately €100,000 on treatment outside that available from the HSE.

Fiona and some of the other sufferers would say that not only is the tragedy of her situation that there are long-term effects, but also that it could have been prevented had there been more awareness among doctors and the general public of Lyme disease. I am aware that some county councils, including Sligo County Council, have provided signage about the dangers of Lyme disease and the possibility that people could be infected in certain areas. I am aware that the resourcing of local authorities to have these signs put up can be an issue. I would love to ensure that all local authorities would be resourced to put up signage providing reliable and easy to understand information about the causes, signs and symptoms of Lyme disease and other tick-borne infections. Sligo County Council has the signs up and I have seen them myself. Could there be standardised signage in woodland areas, public parks and on private land where people go walking? Can it be ensured that there will be regulation of signs and that the local authorities will be resourced to put them up? If the HSE is willing to be involved in the signage, can the local authorities be resourced so that there are people available to put up the signs?

Victor Boyhan (Independent)
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Before I call the Minister of State, I welcome Deputy Feighan and his guests, and all the guests in the Gallery. They are very welcome and I hope they enjoy their visit to Leinster House and the hospitality that comes with it, too.

Kieran O'Donnell (Limerick City, Fine Gael)
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The visitors are in very good hands with Deputy Feighan. They are welcome.

I thank Senator Cosgrove for raising this important matter and for the opportunity to speak on the issue of Lyme disease awareness. I am taking this matter on behalf of the Minister for Health, Deputy Jennifer Carroll MacNeill. Lyme disease, also known as Lyme borreliosis, is an infection transmitted to humans through the bite of infected ticks, and it can occasionally lead to serious illness. Each year, it is estimated that between 200 and 500 cases of early Lyme disease occur in Ireland. Ticks are present throughout Ireland, including both urban and rural areas. Although ticks can be active year-round, the period of highest tick activity and therefore Lyme disease is between April and October. Approximately 5% of ticks in Ireland are thought to carry the bacteria that causes Lyme disease. Importantly, a tick usually needs to be attached to the skin for at least 24 hours before it can transmit the infection. High-risk environments include grassy and wooded areas as well as sand dunes - places where people often enjoy outdoor activities.

The HSE’s national health protection office, through the Health Protection Surveillance Centre, HPSC, provides information on the surveillance of Lyme disease. The HPSC offers a wide range of resources to help people reduce their risk of tick bites, including seasonal updates for both the public and healthcare professionals. Each year in early May, the HSE marks Tick Awareness Day, by providing practical advice on the prevention of tick bites, which can transmit Lyme disease. This is done through website news articles, social media posts, press releases and media interviews. This initiative encourages individuals to take preventive measures during periods when tick activity is highest. Information is provided on common tick habitats, high-risk behaviours, prevention strategies, and how to safely remove and identify ticks. To further spread public awareness, the HSE provides downloadable posters and leaflets that are intended to be distributed in community centres, schools, and recreational and other common public and private spaces, especially those with an increased risk of tick exposure. These materials are designed to inform individuals about the risks of tick bites and the importance of preventive actions. A full suite of Lyme disease resources, including posters and information leaflets, is available through the HPSC website. These posters are suitable for display on publicly accessible land, and the HPSC has actively promoted their availability to Departments and public agencies that manage such areas. Local authorities, healthcare professionals, and members of the public are encouraged to download and share these materials.

Nessa Cosgrove (Labour)
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I thank the Minister of State for his response. Could I get a commitment that all local authorities will be obliged to put up signs? Some have. Kilkenny County Council is bringing it onstream as well. The long-term side-effects are so detrimental and it is something that can be prevented with a bit of awareness. For example, there are signs in Cork. There is a Lyme Resource Centre. There are two QR code on the signs. People can scan one of the QR codes with their phone and that will bring them straight to the HSE information site. The other QR code will bring them straight to the Lyme Resource Centre.

At our meeting - we have this cross-party Oireachtas group - many Lyme sufferers from all around the country came up. Their stories are harrowing. They were looking for a full public awareness campaign and that local authorities would be resourced to put up these signs. The HSE has the posters available for download, but is there any way coming up to the budget that the local authorities could be encouraged that part of the budget will be to resource staff to put these up?

Kieran O'Donnell (Limerick City, Fine Gael)
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I thank the Senator for her comments highlighting the importance of continued action on Lyme disease awareness. I reiterate I am taking this matter on behalf of the Minister for Health.

In 2011, Ireland became one of the first EU countries to make Lyme disease a statutory notifiable disease. The notifiable entity is Lyme neuroborreliosis, a more severe form of the disease which affects the nervous system.

Between four and 21 cases of Lyme neuroborreliosis are notified annually in Ireland, significantly less than the total number of cases of early Lyme infection and family skin infection. However, the levels of Lyme neuroborreliosis serves as a reliable indicator of overall Lyme disease activity in the country.

The HSE, through the HPSC, continues to provide a wide range of public education materials, including an downloadable A3 poster and leaflet entitled, "Protecting yourself against Tick Bites and Lyme Disease", both of which are available on the HPSC website. They are designed to be clear, accessible and suitable for use by local authorities, landowners and public agencies.

The HPSC has also highlighted the availability of these matters to relevant Departments and agencies that manage publicly accessible lands. Members of the public who own and manage land on which people can walk can display the poster in a prominent position at the entrance and exit of the land.

HSE tick-warning signage provides a consistent and evidence-based approach that can be adopted widely. This ensures that the public receive accurate and practical information, particularly in areas where the risk of tick exposure is high.

I will take back to the Minister the particular point that the Senator raises. Might I also suggest that she raises the particular question she has in terms of that issue with the local government section within the Department of housing as well, but I will bring it back to the Minister and the officials in the Department of Health.

Victor Boyhan (Independent)
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I thank the Minister of State. I am most impressed with the Deputy's Latin.

I say "Well done", to everyone and, "Thank you." I particularly thank the Minister of State for giving us of his time. He took three of the Commencement matters. We value him coming to the Seanad. He is always welcome here, as he knows. I thank the Senators for submitting their Commencement matters.