Brendan Griffin (Kerry South, Fine Gael)
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590. To ask the Minister for Health if he will initiate a full review of the diagnostic approach to Lyme disease in view of numerous examples of unsatisfactory patient experience; and if he will make a statement on the matter. [49758/14]

Brendan Griffin (Kerry South, Fine Gael)
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591. To ask the Minister for Health if he will initiate a public information campaign regarding the causes, symptoms and treatment of Lyme disease; and if he will make a statement on the matter. [49759/14]

Leo Varadkar (Dublin West, Fine Gael)
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I propose to take Questions Nos. 590 and 591 together.

Lyme Disease (also known as Lyme borelliosis) is an infection caused by a spiral-shaped bacterium called Borella burgdorferi. It is transmitted to humans by bites from ticks infected with the bacteria. The infection is generally mild affecting only the skin, but can occasionally be more severe and highly debilitating. The commonest noticeable evidence of infection is a rash called erythema migrans that is seen in about 80-90% of patients.

Lyme borelliosis is diagnosed by a medical history and physical examination and can be difficult if there has been no erythema migrans rash. The infection is confirmed by blood tests which look for antibodies to B. burgdorferi produced by an infected person's body in response to the infection. These normally take several weeks to develop and may not be present in the early stages of the disease. The standard approach to Lyme diagnostics is a two-stage approach and involves using a sensitive enzyme immunoassay (EIA) as an initial, screening step. Screening EIA's can be insufficiently specific, giving false-positive reactions in the presence of other spirochaete infections including syphilis, and certain viral infections including glandular fever. In addition, sera from patients with autoimmune disorders and other inflammatory conditions can also lead to false-positive results. Samples giving reactive or equivocal tests in screening tests are further investigated in a second-stage immunoblot (Western blot) tests. Use of immunoblot testing greatly increases specificity. Using this outlined two stage approach will give a great degree of certainty around the diagnosis of Lyme Disease. Testing for Lyme borelliosis is currently undertaken in most of the larger hospitals in Ireland.

There is an ongoing publicity campaign regarding Lyme Disease. The Health Protection Surveillance Centre (HPSC) of the HSE is establishing 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 general public. It will explore ways to ensure these messages are brought to the general public with the frequency and in forms in which they can be most effective.

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 "Tickborne 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.