Does Lyme Disease Need More Funding In Australia?
Labor has promised to dedicate $2.8 million to Lyme disease research and treatment if elected -- but what do we really know about the disease and does it even exist in Australia?
Labor made the funding promise in a statement sent to the Lyme Disease Association of Australia (LDAA) on Saturday.
The LDAA made a pre-budget submission earlier this year that asked for extensive research of Lyme diseases and the establishment of personalised treatment approaches.
The LDAA also asked for tools to facilitate early diagnosis in Australia, such as a large-scale 'biobank' that will track the different biomarkers in people affected by the disease.
Shadow Minister for Health and Medicare, Catherine King, said in the statement that many patients experience "debilitating symptoms" and their suffering is "exacerbated by the poor understanding of their condition."
"Labor hopes that this investment will lead to more certainty on the causes and symptoms of Lyme-like illness, as well as cutting-edge treatments," King said.
While the Liberal government hasn't stood still on Lyme disease -- a Senate inquiry into the disease was launched in 2016, and in 2017 Minister for Health Greg Hunt committed $3 million in a targeted call for research -- advocates say that the science isn't progressing fast enough.
The LDAA argues that the recommendations issued in the final Senate report have not been effectively implemented and did not go far enough in helping to treat the patients who are currently suffering in Australia.
LDAA CEO Sharon Whiteman told 10 daily that Australia is lagging 25 years behind other nations in Lyme disease research and is currently the only country that denies its existence as an endemic infection.
Whiteman said there is a "clear pattern of illness" related to Lyme disease in Australia and estimates that there may be up to a quarter of a million Australians currently suffering from these infections.
Whiteman said that LDAA are excited about Labor's funding commitment to understanding and treating the illness.
So, what exactly is Lyme disease?
Lyme disease is a tick-borne infection that was first recognised in the 1970s.
It is caused by a small family of bacteria that fall under the long-winded name Borrelia burgdorferi sensu lato complex.
A bite from a tick infected with this bacteria typically results in symptoms such as fever, headache, fatigue, sore muscles, joints and a characteristic skin rash.
The rash is known as a bulls-eye rash and it happens in about 50 percent of cases following an infected tick bite.
Why is it so scary?
When left untreated, Lyme disease can result in nerve damage, shooting pains, and paralysis.
In the majority of cases, Lyme disease is treatable with a course of antibiotics but symptoms can persist and this is known as post-treatment Lyme disease syndrome.
Post-treatment Lyme disease syndrome occurs in approximately 10 to 15 percent of patients treated for Lyme and can last for months or years after the initial tick bite.
It is unclear what causes the continuation of these debilitating symptoms but it is thought that patients who experience this syndrome could have residual tissue damage or dysfunctional autoimmune responses.
Here's where it gets complicated.
Lyme disease advocate organisations want to see recognition of chronic Lyme disease (CLD).
This sickness captures the same symptoms as post-treatment Lyme disease syndrome but it it has one critical difference: the existence of CLD relies on the idea that the patient experiences recurring infections of the bacteria.
What's the problem with CLD?
Lyme disease advocate organisations recommend long-term use of antibiotics to treat this condition.
LDAA have even begun to recommend that Australian patients seek treatment in countries such as Mexico, the U.S., Germany, Malaysia, Cyprus and The Netherlands, where these antibiotic courses are available in addition to immune support, heat treatment, oxygen treatments and natural medicine options.
However, neither the existence of CLD nor long-term antibiotic use are supported by the scientific evidence.
Studies have shown that antibiotic therapy does not offer sustained benefit to patients and using antibiotics for long courses actually has significant health risks.
Doctor Brent McParland, a Lyme disease researcher from the University of Sydney, told 10 daily that the widespread use of antibiotics for treating all infected tick bites is a mistake for Australian public health.
"That would be using a lot of antibiotics for just a few that are susceptible [to long-term issues]," he said.
"Every single bush worker is going to be bitten by ticks. Would we want them, as a community, to all be taking antibiotics? I think the answer is probably 'no'".
What's the go with Lyme disease in Australia?
Borrelia burgdorferi sensu lato complex has never been detected in Australia.
Despite extensive searches for signs of the bacteria, the original family of these pathogens have never been found in Australian ticks.
The Department of Health (DOH) state that they "cannot support the diagnosis of a locally acquired classical Lyme disease in Australia without the causative organism or a competent vector being identified".
However, the DOH does acknowledge the existence of a complex range of medical issues in Australia that are attributed to tick bites.
So, where do we go from here?
McParland and Whiteman both agree that there needs to be a broader understanding of the other bacteria carried by ticks that could be causing these medical issues.
"We're only touching the surface of the pathogens that are found within ticks, so to just say that it's only one or two of these bacteria [causing problems] seems kind of funny to me," McParland said.
Whiteman said that the LDAA isn't married to the term 'Lyme disease' and a new term could be accepted in order to broaden understanding of this condition "as long as whatever name we choose is scientific".
"I think it's non-scientific to stick to a single pathogen definition of this disease," Whiteman said.
While McParland believes the Labor-funded 'biobank' may be useful for accumulating patient data and diagnosing people, he would also like to see research funding directed towards understanding whether or not there is a common immune system response that's driving these problems.
"I'd want to find out whether their gut immunity has been altered and if there is, I'd like to see focus on the treatments that would help such patients rather than just using antibiotics."