Michael Healy-Rae (Kerry South, Independent)
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311. To ask the Minister for Health if training on Lyme disease and its effects on children and adults will be offered to general practitioners and public health nurses, as part of their continuing professional development; and if he will make a statement on the matter. [17406/15]

Michael Healy-Rae (Kerry South, Independent)
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312. To ask the Minister for Health if consideration will be given to appointing a rapporteur to carry out a detailed examination, and report on the situation regarding Lyme disease, and for patient representatives to be consulted as part of the process; and if he will make a statement on the matter. [17408/15]

Leo Varadkar (Dublin West, Fine Gael)
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I propose to take Questions Nos. 311 and 312 together.

Lyme disease (also known as Lyme borreliosis) is an infection transmitted to humans by bites from ticks infected with the bacterium Borrelia burgdorferi. The infection is generally mild affecting only the skin, but can occasionally be more severe and debilitating.

Lyme borreliosis is a notifiable infectious disease, the notifiable entity being the more severe neurological form, Lyme neuroborreliosis. The Health Protection Surveillance Centre (HPSC) collects and collates surveillance data on the condition. 20 cases of the condition have been provisionally notified in 2014. This number is likely to fall following validation.

Lyme borreliosis can be asymptomatic or have a range of clinical presentations. Current best advice is that diagnosis should be made only after careful examination of the patient's clinical history, physical findings, laboratory evidence and exposure risk evaluation. Exposure to ticks prior to disease manifestations is necessary for the diagnosis of Lyme borreliosis. Since an awareness or recollection of a tick-bite is not always present, however, this should not exclude the diagnosis of Lyme borreliosis. Later stages require the use of antibody detection tests (or advanced DNA detection techniques). Testing for Lyme Disease is undertaken in most of the larger hospitals in Ireland. In undertaking Lyme testing, it is essential that the results are interpreted in the light of the clinical condition of the patient. If the result of this initial screen is equivocal, the patient's samples are referred to the U.K.'s Public Health England Porton Down facility which uses a two-tier system recommended by American and European authorities. This involves a screening serological test followed by a confirmatory serological test. Because of the general availability of initial screening for Lyme disease in Ireland and the provision of a confirmatory testing service in the UK, there is no need for Irish citizens to travel abroad for testing.

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. Anyone who suspects they may have contracted Lyme Disease should consult their GP who will arrange appropriate testing and treatment.

The Scientific Advisory Committee of the HPSC has established a Lyme Borreliosis Sub-Committee. The aim of this Sub-Committee is to develop strategies to undertake primary prevention in order to minimise the harm caused by Lyme Borreliosis in Ireland. These strategies will be published in a Final Report. In addition to staff from the HPSC, the membership of the Sub-Committee includes specialists in Public Health Medicine, Consultants in Infectious Diseases, Clinical Microbiology, Occupational Health an Entomologist from the Parks and Wildlife Service, a representative from the Local Government Management Agency and an Environmental Health Officer. A representative from the Patients' Association is also being sought. The Terms of Reference of the Sub-Committee are:

- To raise awareness in Ireland of Lyme Borreliosis amongst clinicians and the general public;

- To identify and highlight best international practice in raising awareness about Lyme Borreliosis for the General Public;

- To develop policies of primary prevention of Lyme Borreliosis in Ireland based on best international evidence;

- To explore ways in which to improve surveillance of neuroborreliosis in Ireland;

- To develop strategies to raise awareness among the public particularly in areas of higher tick populations;

- To produce a Final Report covering all the above areas.

The Sub-Committee will hold its inaugural meeting today.

With regard to continuing professional development, the content and composition of professional competence schemes for general practitioners is a matter for the Medical Council and the recognised postgraduate training bodies. In line with the provisions of the Medical Practitioners Act, as of May 2011, doctors are legally obliged to maintain their professional competence by enrolling in approved professional competence schemes and following requirements set by the Medical Council. In this context, the Council has established a range of professional competence schemes through formal arrangements with the recognised postgraduate training bodies. Schemes are operated by the postgraduate training bodies and have been developed to drive good professional practice, which is centred on patient safety and quality of patient care.

Should a specific service need for continuing professional development for public health nurses be identified, it would be addressed and delivered utilising a collaborative approach involving the registrant, health service provider/employer and educators. Stakeholders include the HSE-Office of Nursing and Midwifery Services Director, the Centres for Nursing and Midwifery Education and School of Nursing and Midwifery within the higher education sector.