Dáil Éireann Debate, Tuesday - 6 December 2016
375. Deputy Charlie McConalogue asked the Minister for Health the steps he will take to ensure awareness in the community with regard to the causes and symptoms of Lyme disease and to ensure that the medical profession and health service are equipped to deal with the illness and its presentation; and if he will make a statement on the matter. [38769/16]
View answerLyme disease (also known as Lyme borreliosis or LB) is an infection caused by a spiral-shaped bacterium called Borrelia burgdorferi that 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. Lyme disease is the commonest cause of tick-borne infection in Europe.
The Health Protection Surveillance Centre (HPSC) of the HSE collects and collates surveillance data on notifiable infectious diseases. Lyme borreliosis is notifiable in Ireland since 2012; the notifiable entity being the more severe neurological form of LB: Lyme neuroborreliosis.
The number of annual neuroborreliosis notifications over the last few years is as follows:
- 2012 – 8 cases;
- 2013 – 13 cases;
- 2014 – 18 cases;
- 2015 – 12 cases.
This gives an average annual incidence rate of neuroborreliosis in Ireland of about 2.7 neuroborreliosis cases per million population.
Since 2013, the HPSC has held an annual ‘Lyme Awareness Week’ at the beginning of the tick biting season, the purpose of which is to draw attention - particularly in the media - to Lyme disease and the ticks that can spread this disease. The week beginning May 2nd was designated as Lyme Awareness Week this year.
The literature on the HPSC website points out that campers, walkers and certain occupational groups such as forestry workers, conservation workers, deer cullers and farmers are at particular risk of exposure to ticks (and therefore LB). That said, anyone walking or hiking in the countryside is at risk of biting ticks. The ticks responsible for LB are generally hard-bodied ticks (Ixodidae). Ixodes ticks are hosted by a wide range of mammals including deer, sheep and cows, and occasionally birds; their tiny size (less than 2mm unfed) means they can remain undetected for long periods.
Ixodes ticks are most likely to be found in:
- Shady and humid woodland clearings with grass;
- Open grassland, walking paths (especially those bordered by long grasses);
- Wooded and forested areas;
- Vegetation close to lakes and seaside beaches;
- Parkland areas; and
- Open fields and bushes.
They are present in both urban and rural environments and are active from spring to autumn. Lyme cases tend to appear in Ireland with greater frequency after April, hence the choice of this time of year for Lyme Awareness Week.
Both the Health Protection Surveillance Centre and Tick Talk Ireland provide guidance on protection against contracting Lyme borelliosis. The best protection is to prevent tick bites, when walking in grassy, bushy or woodland areas, particularly between May and October:
- Arms and leg should be covered; wearing long trousers tucked into socks or boots, and long-sleeved shirts with cuffs fastened is advised. Shoes or boots should be worn rather than open-toed sandals.
- The use of insect repellent on clothes is recommended, or on limbs if it is not practicable to cover up. DEET or permethrin (insect repellents) can be used – advice can be obtained from pharmacies.
- Skin and clothing should be inspected for ticks every three to four hours and children's skin and clothes checked frequently.
- Ticks should be removed as soon as they are seen attached to the skin. Further advice on tick removal can be obtained from the HPSC website.
- It is not recommended that antibiotics are given to prevent the transmission of Lyme disease following a tick bite. Only if the area becomes inflamed may treatment be required; and advice should be sought from a doctor.
- People should see their doctor if they develop a rash or become unwell with other symptoms, letting the doctor know of exposure to ticks.
Further advice can be obtained from the HPSC website (www.hpsc.ie) and the HPSC produced a leaflet on “Protecting Yourself Against Tick Bites and Lyme Disease” which is available for the public to download.
In addition, a Lyme Borreliosis Subcommittee has been established to look at methods of raising awareness especially in those areas (including recreation areas) where Lyme carrying ticks can be most expected to be found.
