Brendan Griffin (Kerry South, Fine Gael)
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418. To ask the Minister for Health the standard approach to treating Lyme disease, Lyme borelliosis; the way this compares to other countries; and if he will make a statement on the matter. [10325/15]

Leo Varadkar (Dublin West, Fine Gael)
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Lyme disease, also known as Lyme borelliosis, is an infection caused by a bacterium (Borrelia burgdorferi). It is transmitted to humans by bites from ticks infected with the bacterium. Lyme borelliosis was made statutorily notifiable in Ireland by the Infectious Diseases (Amendment Regulations) Regulations 2011.

Lyme borelliosis is diagnosed by 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. burgdorferiproduced 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 EIAs 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 results in screening tests are further investigated in a second-stage immunoblot (Western blot) tests. Use of immunoblot testing greatly increases specificity. Using this two stage approach will give a great degree of certainty around the diagnosis of Lyme.

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 up to three weeks. If complications develop, intravenous antibiotics may need to be used.

The standard approach to treatment of Lyme borelliosis is to follow the guidance laid out in the Infectious Diseases Society of America (IDSA) guidelines on the Clinical Assessment, Treatment, and Prevention of Lyme Disease, Human Granulocytic Anaplasmosis, and Babesiosis: Clinical Practice Guidelines by the Infectious Diseases Society of America. This is accepted as being the most up to date synthesis of best available evidence on the clinical management of Lyme borelliosis. Treatment of Lyme borelliosis in Ireland is based upon this guidance.

A consensus statement on the clinical management of Lyme borelliosis was been issued jointly from the Scientific Advisory Committee of the Health Protection Surveillance Centre, the Infectious Diseases Society of Ireland, the Irish Society of Clinical Microbiologists, the Irish Institute of Clinical Neuroscience and the Irish College of General Practitioners in November, 2012 supporting the use of this guidance.

There were 20 cases notified in 2013 and 20 notified cases in 2014, it is expected that this figure will reduce on validation. In the first seven weeks of 2015, two cases have been notified compared to 4 for the first seven weeks of 2014.