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September 27, 2021

Lyme disease confusion

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Lyme disease is a controversial name and a very misunderstood disease but the global debate over a name does not help patients receive the treatment they need. Technically the name Lyme disease refers to infection with Borrelia burgdorferi sensu stricto bacteria, common in the east coast of USA. In Europe and in Russia it is called Lyme Borreliosis and caused by the Borrelia burgdorferi sensu lato group which the American Borrelia is a member of. The rest of the world (including our neighbours, Indonesia, Thailand, Japan and India) has the relapsing fever Borrelia. All three should be called Borreliosis, which is a complex infection with delayed onset, vague symptomology.

Awareness among clinicians is very low in Australia, Africa, and Asia. Diagnosis is difficult as most people do not recall a tick bite and a tick bite not only delivers Borrelia but multiple co-infections that may be parasitic, and the malaria-like Babesia or viral-like tick-borne encephalitis virus (TBE).

Co-infections complicate the diagnosis and treatment. Increasing number of co-infections are likely to cause more serious symptoms and may also cause immuno- suppression.

Current Australian tests are based upon the American Borrelia and cannot detect relapsing fever Borrelia.

This is inappropriate and hence why some Australians send their blood overseas for testing. The Royal College of Pathologists advice about overseas labs ignores the fact that NATA accreditation in Australia refers to ISO 1589 accreditation therefore any overseas lab that is ISO1589 accredited is equal to NATA accreditation.

A study 20 years ago could not identify the spirochete in Australian ticks. However it is agreed that there is something in Australian ticks that is causing Lyme-like disease. The causative agent has not yet been characterised or isolated.

Because of lack of training, awareness and clinician unfamiliarity with Borreliosis, Australians are not diagnosed and treated appropriately whether they have been bitten by ticks in Australia or overseas. With greater awareness, more research, improved diagnosis and testing those affected can be treated.

While some may be confused over what is in a name, others like Ms Taylor (Articles, May 20), working alongside the Karl McManus Foundation, do an excellent job raising awareness of such an insidious disease to ensure more people receive the treatment they need.

The Karl McManus Foundation is hosting the 2nd Tick Borne Diseases Conference in Sydney, June 14–15. Ms Hamilton is welcome to attend.

Dr Mualla McManus, director, Karl McManus Foundation


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