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Health Services Provision

Dáil Éireann Debate, Tuesday - 28 April 2015

Tuesday, 28 April 2015

Ceisteanna (263, 264, 322)

Tom Fleming

Ceist:

263. Deputy Tom Fleming asked the Minister for Health the reason patients who test positive for Lyme disease in other European Union countries are not given access to treatment here; and if he will make a statement on the matter. [16386/15]

Amharc ar fhreagra

Tom Fleming

Ceist:

264. Deputy Tom Fleming asked the Minister for Health his views on a meeting on Lyme disease by the Oireachtas health committee (details supplied); and if he will make a statement on the matter. [16387/15]

Amharc ar fhreagra

Pat Deering

Ceist:

322. Deputy Pat Deering asked the Minister for Health the reason patients who test positive for Lyme disease in other European Union countries are not provided with treatment here. [16676/15]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

I propose to take Questions Nos. 263, 264 and 322 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 on May 6.

Each year the HPSC holds a Lyme Awareness Week. This involves raising awareness for clinicians and the general public as to the risks of infected biting ticks, protection against tick bites and identifying the disease. Much use is made of the media to broadcast these messages in addition to the extensive material provided on the HPSC website. This year's Lyme Awareness Week takes place from April 27 to May 1st.

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