Dáil Éireann Debate, Thursday - 5 April 2007
232 Mr. Gormley asked the Minister for Health and Children when she will make Lyme disease notifiable, making it obligatory for doctors to report cases to their local Director of Public Health; the actions being taken to raise public awareness of this disease; and if she will make a statement on the matter. [13678/07]
Amharc ar fhreagraLyme Disease (also known as Lyme borelliosis) 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 sometimes be more severe.
Lyme Disease has been reported from North America, Europe, Australia, China and Japan. They feed by biting and attaching to the skin and sucking blood, normally from animals such as sheep and deer. Infected ticks are most likely to be encountered in heath land and lightly forested areas of North America and Northern Europe. Ramblers, campers and those who work in such areas especially if they come into contact with large animals are at greatest risk of being bitten by ticks and of going on to develop disease. Cases of Lyme Disease appear in Ireland every year.
Lyme disease is not a notifiable infectious disease in Ireland. This means that there is no legal requirement on doctors to report cases to their local Director of Public Health, so this makes estimates of incidence difficult. The schedule of infectious diseases is reviewed on a periodic basis and inclusion of Lyme disease will be considered in the next review.
Many infected people have no symptoms at all. The commonest noticeable evidence of infection is a rash called erythema migrans that is seen in about three-quarters of infected people. This red, raised skin rash develops between 3 days and a month after a tick bite and spreads outwards from the initial bite site. This rash can last up to a month and be several inches in diameter. People can also complain of ‘flu-like symptoms such as headache, sore throat, neck stiffness, fever, muscle aches and general fatigue. Occasionally, there may be more serious symptoms involving the nervous system, joints, the heart or other tissues.
In Ireland, researchers have tried to determine levels of Lyme borelliosis; it has been estimated that there were about 30 human cases per year in the mid-1990s. Data, however, from the National Virus Reference Laboratory which is responsible for undertaking testing for B. burgdorferi has confirmed that there were only 11 positive cases in 2003; these numbers have been steady at that level for the last couple of years. There were, however, more than 1,000 requests for testing for B. burgdorferi in 2003. Over the last several years, the NVRL confirms that virtually all positive cases were associated with travel in the US. It is felt that there is some, unknown degree of underreporting and under diagnosis of this condition.
It would, therefore, appear on initial review, that despite confirmed Irish cases of Lyme borelliosis having been principally associated with travel to North America, there is the potential for individuals to be exposed to biting ticks in Ireland. It would seem sensible for this reason, to recommend that simple, straightforward information should be made available that will assist those who may potentially be exposed (whether as a result of occupational or leisure activities) to take necessary precautions. As a response to this in 2004, the Vectorborne Subcommittee of the Scientific Subcommittee of the Health Protection Surveillance Centre's (HPSC) Scientific Advisory Subcommittee was established. One of its terms of reference was to identify and determine the burden of certain significant vectorborne diseases in Ireland and to make recommendations in relation to the provision of advice and guidance.
A fact sheet on Lyme Disease has been made available on the HPSC's website to provide members of the General Public and Media with advice on minimising the risk of Lyme Disease (additional incidence information appears here). In addition, part of the work of the Vectorborne Subcommittee will be the development of Clinical Guidance on the management of Lyme Disease and raising awareness of this condition among clinicians.
