Written answers
Tuesday, 1 October 2013
Department of Health
Disease Management
Jerry Buttimer (Cork South Central, Fine Gael)
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611. To ask the Minister for Health the diagnosis and treatment facilities available for Lyme disease and if there are plans to expand these facilities; and if he will make a statement on the matter. [40985/13]
James Reilly (Dublin North, Fine Gael)
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Since September 2011, Lyme disease has been a notifiable disease under the Infectious Diseases Regulations. The standard approach to the treatment of Lyme Disease is to follow the guidance laid out in the Infectious Diseases Society of America guidelines on the clinical assessment, treatment and prevention of Lyme disease. This is accepted as being the most up to date synthesis of best available evidence on the clinical management of Lyme disease and treatment of Lyme Disease is based upon this guidance.
The acute tertiary hospitals in Ireland have the diagnostic and treatment facilities and personnel for the management of Lyme disease. In addition, a network of infectious disease specialists is available in all the major centres to provide consultative, expert advice in the management of Lyme borreliosis. I am advised by the Health Protection Surveillance Centre that there were eight cases of Lyme neuroborreliosis notified in 2012. Lyme neuroborreliosis is at the more severe end of the spectrum of Lyme borreliosis and as such it is possible that there may be more people with the milder form of the disease. Given the numbers of cases of Lyme borreliosis in Ireland, I am confident that the facilities available for the diagnosis and treatment of the condition are commensurate with the burden which the disease imposes.
Comments
Ann Maher
Posted on 4 Oct 2013 7:21 pm (Report this comment)
.Quote " Lyme neuroborreliosis is at the more severe end of the spectrum of Lyme borreliosis"
Patients here mostly suffer from Lyme Neuroborreliosis, because Diagnosing and Testing is not reliable.!
Quote " The standard approach to the treatment of Lyme Disease is to follow the guidance laid out in the Infectious Diseases Society of America guidelines on the clinical assessmente , treatment and prevention of Lyme disease, "
Very few patients here in Ireland get diagnosed early on .What a shame because It could prevent the Later stage which results in chronic Lyme disease
Jennifer O'Dea
Posted on 3 Oct 2013 12:52 pm (Report this comment)
I do worry about the lack of concern when it comes to Lyme Disease in Ireland. Firstly relying on 8 reported cases as proof of it's rarity is not sufficient for several reasons..
1. the doctor or consultant has to think of Lyme disease in their differentials - doctors & I've heard some consultants are still unfamiliar with the fact that Lyme can be contracted in this country & therefore wouldn't test for it. In fact in our surveys we found that 60% of our patients were infected in Ireland & not abroad, showing that it is a problem here & shouldn't be ignored.
2. the symptoms mimic so many other diseases that misdiagnosis can often occur, even agreed by the HPSC who wrote an article on it. In fact the most common misdiagnosis is ME/CFS & there are approx 12000 patients with CFS in Ireland, so how many of those have an infection & not know it or even be tested for it?
3. the tests don't pick up all strains, for example in Ireland strain VS116 was found in 50% of ticks sampled in a study by Prof Gray & this strain has been found in EM & spinal fluid of patients in studies & warrants more testing. Only 3 strains are regularly tested & yet more strains are being identified across US & Europe.
4. the patient does not always exhibit a strong enough antibody response to testing (it can be affected by early treatment for example, however early treatment is vital). You could even have a scenario where a patient was treated early at stage one phase but still continued to develop further symptoms however their test results may never sero convert & so any ongoing symptoms are put down as of mental origin or a depressive illness. In our surveys we found that patients are being diagnosed more & more with depression & anxiety & their physical symptoms are not addressed.
5. the notifiable cases are far too narrow, stage one & two patients aren't recorded therefore you are only recording the tip of the iceberg.
Patients can also find themselves being treated for too short a period such as 2 weeks which may be insufficient for a disseminated condition. This can lead to complications later on which again may be put down to chronic fatigue syndrome or depression/anxiety.
Therefore, it's easy to see that 8 notified cases maybe extremely under reported..