Lyme disease, and whether or not it exists in Australia, is highly controversial.
An increasing number of Australians are becoming chronically ill after a tick bite. But the current stance of the Australian Government is that classical Lyme disease (and its usual co-infections) cannot be contracted in Australia. This is due to the belief that the bacteria (Borrelia burgdorferi) that causes Lyme does not exist here.
This perspective is based on 1994 research that failed to find Borrelia in Australian ticks (tick bites being the most common way to contract the bacteria). However, earlier and later studies have found Borrelia species in ticks removed from Australian fauna, domestic animals and cattle.
Evidence of Lyme in Australia
- Compilation of evidence, 2019. Black Dot Project.
- Evidence of Lyme disease in Australia. Article from the Sydney Morning Herald, 1989.
- Lyme Borreliosis: An Australian Perspective. (Abstract). This is the 1995 thesis of Dr Michelle Wills.
- Analysis of Lyme Borreliosis: An Australian Perspective. The LDAA published this document in 2017, after Dr Wills’ thesis was made publicly available.
- Evidence for a Lyme-like illness in Australia. Extract from Australian Chronic Infectious and Inflammatory Diseases Society (ACIIDS) Submission 370 to 2016 Senate Inquiry.
- In 2016, Australian researchers at Murdoch University in Perth found a new species of Borrelia in their study of 97 echidna ticks, with 39% of the ticks carrying the Borrelia bacteria*
- IGeneX immunoblot tests find Lyme in Australian blood samples. In a study of 100 Australian patients, 21% had been exposed to Borrelia burgdorferi sensu lato, the causative agent of Lyme disease, 18% to the tick-borne relapsing fever Borrelia group, while a further 7% were exposed to both groups of Borrelia.
- Epidemiological evidence found within 2016’s Senate Inquiry submissions.
There is no question that the bacteria Borrelia exists in Australia, however there is currently no test designed to detect known Australian species.
If the disease Australians are suffering manifests itself as classical Lyme, if thousands of Aussie patients’ lab tests have returned positive results for Borrelia, and they respond well to Lyme treatments, why not call it Australian Lyme?
Current Health Policy
There are thousands of Australians who have the symptoms of Lyme disease, and some have had the tell-tale Lyme “bullseye” rash after a tick bite.
The Department of Health will not entertain the possibility that these people have Lyme disease unless those patients have travelled overseas. If they haven’t, their advice to doctors is “Do not test for Lyme disease”, regardless of the symptoms observed.
If the patient has travelled overseas and has Lyme symptoms, they will be referred to an infectious disease specialist with the possibility of an official Lyme diagnosis. If a recognised tick-borne disease is suspected, they may be referred to an infectious disease specialist. If they do not fit into one of those two groups, the Department of Health dictates that the illness be called “DSCATT – Debilitating Symptom Complex Attributed to Ticks” though this is not a diagnosis. If following the DSCATT Clinical Pathway (The Department of Health’s doctor’s guide for tick-borne diseases), symptom management is the best a doctor in the mainstream medical system can do.
The result of current government policy and the lack of research into Australian Lyme disease and other tick-borne pathogens, is thousands of very ill patients with “DSCATT” (we prefer the more accurate name – Australian Lyme disease) who are being denied a diagnosis, appropriate care and support.
Current Australian policy documents regarding DSCATT (NB. The LDAA strongly disputes the term DSCATT and the DSCATT Clinical Pathway).
There is a very wide gap between the government’s perspective, and the LDAA’s anecdotal evidence from hundreds of patients; many of whom have positive Lyme tests from laboratories outside Australia.
Patients are forced to quietly seek diagnosis and treatment from the few Lyme-literate doctors in Australia; though these doctors’ registrations may be at risk if they were reported. Some patients consult with a Lyme-literate practitioner or clinic overseas (via Skype or travelling to clinics), or find a complementary practitioner, perhaps a Lyme-literate naturopath who is able to diagnose and treat Lyme without professional repercussions.
How big is the problem?
Due to the Government’s “Lyme denial” there is no official data that may help to quantify the size of the Lyme problem in Australia.
There has been no epidemiological study or surveillance mechanism established.
No investment into research on Lyme disease, its causative agent or its aetiology occurred in Australia for twenty years. In that time, seven new Borrelia genospecies were isolated internationally.
The Lyme Disease Association of Australia has been collecting anecdotal information from patients identifying with Lyme disease. These patients have a confirmed diagnosis of Lyme by a doctor.
Our data indicates that Lyme is non-discriminatory. It can affect anyone in major cities, urban, regional, rural and remote locations. On average, it takes a patient ten years to gain an accurate diagnosis.
If Australia were to use a similar prevalence rate to that reported in the US, over the past 20 years there may be up to 496,153* Australians who have acquired Lyme. That’s up to 20,000 cases per year.
* Estimated 0.09% incidence pa x ABS Population statistics cumulated yearly since 1994
Lyme is controversial internationally as well.
In some countries, it is considered to be “hard to get and easy to treat” with chronic Lyme being widely denied. In the US there exists two opposing views on the length and type of treatment and research can support either side of the argument (Infectious Disease Society of America – IDSA and International Lyme and Associated Diseases Society – ILADS). Australian authorities have imported this controversy. The LDAA generally favours the ILADS position and treatment protocol.
Diagnostic protocols and testing
Generally, the diagnostic protocols, processes and tests used in Australia, that are recommended by mainstream practitioners, are inappropriate. Some Australian laboratories produce discordant test results.*
Independently, or with assistance from a Lyme-literate practitioner, patients routinely send their blood overseas for testing in specialist laboratories at significant expense. (See Lyme Diagnosis). International laboratories commonly used by patients meet the highest international standards. Under international agreements, they are eligible for reciprocal recognition through the National Association of Testing Authorities (NATA). And yet their results are dismissed by Australian health authorities.
See also Lyme Diagnosis
* Baggoley, C (former Chief Medical Officer) 2016, Health Media Statement, Media Release, Woden, Canberra, February 2016
Lack of education
The Australian medical community and the general public are under-educated on emerging illnesses that can follow a tick, or other vector bite. Doctors need better support, contemporary research and unambiguous guidelines that keep pace with emerging research. Our communities need information and education about the prevention of tick-borne disease with advice on protection strategies.
At this point in time, most Australians (including doctors) would not necessarily connect symptoms of ill health with a recent tick bite. And that is why so many patients suffer, unnecessarily, for years without a diagnosis.
How you can help
Join the Patients First #aussielymefight campaign.
The LDAA is more committed than ever to supporting the Australian Lyme and associated diseases community.
* Loh, S. M., Gofton, A. W., Lo, N., Gillett, A., Ryan, U. M., Irwin, P. J., & Oskam, C. L. (2016). Novel Borrelia species detected in echidna ticks, Bothriocroton concolor, in Australia. Parasites & vectors, 9(1), 339. doi:10.1186/s13071-016-1627-x.
Copyright Lyme Disease Association of Australia