A year-long Australian Senate inquiry into ‘Lyme-like illness’ has recommended dedicated funding for research into the condition and into potential vector ticks, and a clinical trial of treatment guidelines created by national groups that support the existence of endemic Lyme disease in Australia.
The final report of the Senate Community Affairs Reference Committee, titled ‘Growing evidence of an emerging tick-borne disease that causes a Lyme-like illness’ also recommended, “as a matter of urgency”, a national summit to develop a cooperative multidisciplinary framework to address tick-borne illness.
More than 1200 submissions
The existence of endemic Lyme disease in Australia has been a controversial topic for many years. The committee report said it received more than 1200 submissions from “professionals articulating considered, plausible, yet contradictory views”.
“This evidence, presented … mirrored the tangled public discourse which has been going around in circles for years: do pathogens responsible for Lyme disease exist in Australia, which pathology results are reliable, who do we believe?”
An Australian Department of Health spokesperson was unable to comment immediately after the report’s release, however its website states that many Australians associate their “chronic debilitating symptoms” with a tick bite. NSW (New South Wales) Health, in its online
NSW (New South Wales) Health, in an online fact sheet advises that although locally acquired Lyme borreliosis cannot be ruled out, there is little evidence that it occurs in Australia.
Clinical treatment guidelines
The report’s recommendations include:
- Increased funding for research into tick-borne pathogens as a matter of urgency, including funding for research on pathogens that may cause infection and on whether newly identified pathogens can cause illness in humans; and funding for development of diagnostic tests to detect infection by any newly identified pathogens endemic to Australia
- Government medical authorities, in consultation with stakeholders including the Australian Chronic Infectious and Inflammatory Diseases Society (ACIIDS) and the Karl McManus Foundation, establish a clinical trial of treatment guidelines developed by ACIIDS with the aim of determining a safe treatment protocol for patients with tick-borne illness
- Funding for research into medically appropriate treatment of tick-borne disease, and measuring the value of treatment in terms of patient recovery and return to health. The best treatment options to then be developed into clinical treatment guidelines
- An urgent summit to develop a cooperative framework which can accommodate patient and medical needs with the objective of establishing a multidisciplinary approach to addressing tick-borne illness across all jurisdictions
- Australian medical authorities and practitioners addressing suspected tick-borne illness adopt a patient-centric approach focusing on individual patient symptoms, rather than a disease label, and remove ‘chronic Lyme disease’, ‘Lyme-like illness’ and similar ‘Lyme’ from diagnostic discussions
- To help referral of patients for guided and comprehensive pathology testing, medical practitioners work with pathologists, especially microbiologists, immunologists, chemical pathologists and hæmatologists to optimise diagnostic testing for each patient
- The Department of Health work closely with the Australian Medical Association and Royal Australian College of General Practitioners to ensure that general practitioners have a better understanding of how to treat patients who present with complex symptoms.
Research expensive to do
A long-time researcher of tick-borne disease, Professor Peter Irwin from Murdoch University’s College of Veterinary Medicine in Western Australia, said the problem for patients with ‘Lyme-like illness’ was that, once they sought medical attention, they ran into problems.
“We are one of several groups who’ve been working on this for a while. There needs to be dedicated money put aside for this problem, so that we can drill down into [health problems of] people bitten by ticks.
“All our previous and ongoing research is on the ticks, but we’ve moved into the human field because we have the right methodology to apply to humans, and we have medical people with us. But it’s expensive to do, it’s advanced molecular biology and you need large numbers of people, but only a small proportion [of people bitten by ticks] develop any illness.”
Dr Miles Beaman, an infectious diseases physician and clinical microbiologist from Western Diagnostic Pathology in Perth, said the committee’s recommendations were all “sensible suggestions but, as with all things government, they won’t amount to anything unless the talk is turned into action”.
“Funding is the critical issue, and it should be for multidisciplinary groups with expertise in clinical infectious diseases, laboratory pathology and basic microbiology research – those with experience in the scientific method).”
The Australian Chronic Infectious and Inflammatory Diseases Society and the Karl McManus Foundation did not respond to requests for comment on the report.
