The official stance has long been that there is no Lyme disease in Australia, but things could be set to change with a new Lyme disease committee established this year. The view of Australia being ‘Lyme-free’ not only affects awareness of Lyme disease prevention but also access to diagnostic procedures and coverage by insurers of basic antibiotics for Lyme disease. The reality is that ticks have been found on every continent, with the exception of Antarctica, and that global warming has affected the spread of ticks through enhanced ability to survive in previously uninhabitable areas. Lyme disease tick hotspots do exist in Australia and it is important that residents and travellers alike know where the risk is high.
Things may be looking up for those in Australia, however, as earlier this year a letter was distributed by the Australian Government Chief Medical Officer, Professor Chris Baggoley, to all general physicians outlining a plan to investigate the possible presence of Lyme disease in the country. Establishing a Clinical Advisory Committee on Lyme disease (CACLD), Baggoley intends to gather information on the presence, diagnosis, and treatment of Lyme disease in Australia as well as to allow the committee to provide advice on the best ways to disseminate information to health professionals and the general public. Whether this leads to a policy change remains to be seen but the mere fact that the government is reassessing the situation is cause for hope.
Lyme Disease Hotspots in Australia
In New South Wales the area around Coffs Harbour is particularly rife with the ticks that can carry Lyme disease bacteria. The northerly beaches in Sydney, and the westerly suburbs of Sydney are also known to be tick hotspots. The south coast of New South Wales is another area in which caution should be exercised when spending time outdoors, making sure to use tick repellants and wear appropriate clothing to reduce your risk of tick bite.
Mapping Australia Lyme Disease
Ticks can carry a range of different bacteria, which is why Lyme disease often appears alongside co-infections such as Babesiosis or Ehrlichiosis. The Lyme Disease Association of Australia (LDAA) is currently mapping known incidents of Lyme disease in the country, along with tick bites that led to Lyme disease in the hope of producing an accurate resource for those keen to avoid the risk of infection.
The Dangers of Lyme Disease Denial
The misconception of there being no Lyme disease in Australia is based in the idea that all cases that have occurred in the country are a result of tick bites received overseas. However, there have been multiple cases where a person has tested positive for Lyme disease having not left the country for many years or ever. Official policy still seems to rest on a report carried out in 1994, almost twenty years ago, by Russell and Doggett. This report is not only woefully out of date but was also subject to some methodological flaws even at the time of its publication.
Australia Ticks Carrying Lyme Disease Bacteria
Another researcher, however, did find ticks carrying the Lyme disease bacteria in 1995, and an even older study by Carly and Pope found an Australian strain of Borrelia, Borrelia Queenslandica in 1962. Animals carrying Lyme disease bacteria, Borrelia, were the subject of a paper published in 1959 by Mackerras which identified the infection in kangaroos, wallabies, and bandicoots. Whereas the ticks that carry Lyme disease are often known as deer ticks in the US, they may never even encounter a deer in Australia or in the US for that matter. This nomenclature can lead to a false sense of security in areas where deer are absent.
Positive for Lyme Disease in Australia
Research carried out by Mayne in 2011 looked at those with symptoms of Lyme disease, with the majority of the 51 patients having not had recent overseas travel. Over half (55%) of these patients tested positive for Lyme disease and 32% of those tested for co-infections (41 patients) were positive for Babesiosis, and nine (22%) were positive for Bartonella. Ehrlichiosis was diagnosed in 25 of the patients and 16% had Anaplasmosis. Almost half of all those positive for Lyme disease (41%) were also positive for Babesia. One patient who had never left Queensland tested positive for Lyme disease, Babesia duncani, Babesia microti, and Bartonella henselae. A further three patients who had not travelled further than the east coast of Australia also tested positive for these infections.
More Evidence of Lyme Disease in Australia
Further evidence of Lyme disease in Australia was published by Mayne in 2012, with cases presented of four patients attending the doctor’s practice with erythema migrans between 2010 and 2011. These patients underwent polymerase chain reaction testing on skin samples taken from the area of the Lyme disease rash and tested positive for Lyme disease bacteria.
200,000 Lyme Disease Cases Undiagnosed in Australia?
The LDAA states that there are some 15,000 people diagnosed with Lyme disease in Australia and around 200,000 estimated undiagnosed cases. When doctors are under the impression that Lyme disease is not just rare but impossible in Australia this does not lead to prompt diagnosis and treatment. As Lyme disease is much easier to treat in the early stage of the infection, before serious tissue damage has occurred, this delay in diagnosis and antibiotic therapy leaves many patients vulnerable to considerably more severe symptoms than in countries where Lyme disease is accepted as a potential diagnosis early on (such as in Germany).
Lyme Disease Misdiagnosis
Lyme disease may be misdiagnosed as many different diseases and conditions, including Multiple Sclerosis, Parkinson’s disease, lupus, fibromyalgia, motor neurone disease, and chronic fatigue, or even psychiatric illness such as depression or schizophrenia. As Lyme disease tests are notoriously unreliable and unlikely to be accessible in Australia, many patients end up paying for their own diagnosis via labs in the US, some of which have been found to have high rates of false positives and/or flawed protocols.
Australia Government and Lyme Denial
By denying the existence of Lyme disease in Australia, the government has been accused of being complicit in the prolongation and exacerbation of Lyme disease symptoms and suffering. However, various resources do exist for those in Australia who suspect that they have Lyme disease, mainly through the work of the LDAA, and some residents have taken it upon themselves to mount protests about Lyme disease policy in the hope of gaining better recognition of the illness.
Carley, JG, Pope JH. A new species of Borrelia (B. queenslandica) from Rattus villosissimus in Queensland. Aust J Exp Biol Med Sci. 1962 Aug;40:255-61.
Mayne PJ. Emerging incidence of Lyme borreliosis, babesiosis, bartonellosis, and granulocytic ehrlichiosis in Australia. Int J Gen Med. 2011;4:845-52.
Mayne PJ. Investigation of Borrelia burgdorferi genotypes in Australia obtained from erythema migrans tissue. Clin Cosmet Investig Dermatol. 2012;5:69-78. doi: 10.2147/CCID.S31913. Epub 2012 Jul 5.
Russell RC. Lyme disease in Australia–still to be proven! Emerg Infect Dis. 1995 Jan-Mar;1(1):29-31.
Russell RC, Doggett SL, Munro R, Ellis J, Avery D, Hunt C, Dickeson D. Lyme disease: a search for a causative agent in ticks in south-eastern Australia. Epidemiol Infect. 1994 Apr;112(2):375-84.