Dáil Éireann Debate, Wednesday - 16 January 2013
993. Deputy Derek Nolan asked the Minister for Health further to Parliamentary Question No. 648, if he will consider reviewing the guidelines from the International Lyme and Associated Diseases Society, rather than the guidelines of the IDSA, which Ireland currently follows in view of the fact that the two sets of guidelines make for different reading in dealing with lyme disease; and if he will make a statement on the matter. [58149/12]
View answer996. Deputy Derek Nolan asked the Minister for Health if, following information received from Tick Talk Ireland in March, a response will be issued to them about the problems they identified in testing for and diagnosing Lyme disease; and if he will make a statement on the matter. [58154/12]
View answer1018. Deputy John McGuinness asked the Minister for Health the steps he or the Health Service Executive have taken relative to the care of the needs of those with Lyme Disease; his response to those involved in a campaign to have the disease properly recognised; and if he will make a statement on the matter. [1115/13]
View answerI propose to take Questions Nos. 993, 996 and 1018 together.
Since September 2011, Lyme Disease has been statutorily notifiable 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 (IDSA) 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 in Ireland is based upon this guidance. A consensus statement on the clinical management of Lyme Disease has 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, all of whom support the use of this guidance.
The diagnosis of a case of Lyme Disease can be difficult. The standard approach to Lyme diagnostics is a two-stage approach and involves using a sensitive enzyme immunoassay (EIA) as an initial screening step. However, screening EIA's can be insufficiently specific and can give other false-positive reactions in the presence of various other infections from syphilis to 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 test. The use of immunoblot testing greatly increases specificity. Using this two stage approach gives a greater degree of certainty around the diagnosis of Lyme Disease.
A response to Tick Talk Ireland will issue shortly.
