Clock ticking on Lyme disease controversy

ONE side says it doesn't exist here, the other says 10,000 people may have it.

Adult female tick

IT can start with a niggling itch behind the ear, or perhaps a funny bump along the hairline. For the millions of Australians who choose to live nestled in bushland along the east coast, tick bites are an annoying fact of life requiring constant vigilance.

While many people will pry the tiny parasites from their skin without a second thought, for others the bloodsuckers' bite can have life-changing consequences as a range of toxins are introduced that can take days, weeks or months to reach their full effect.

"Ticks are nature's dirty needles, and 99 per cent of Australians are ignorant of the pathogens that ticks carry," says Mualla McManus, who is in a better position than most people to know about the dangers of ticks. Her husband, Karl, died three years after receiving a tick bite while working as a crew member on the Seven Network's Home and Away, from complications she believes were due to Lyme disease.

The existence of Lyme disease in Australia has been hotly debated for decades, but an investigation by Australia's chief medical officer is under way that could finally lead to consensus among doctors and their tick-bitten patients, who increasingly flock to online support forums.

A quick look at recent posts to the Lyme Disease Association of Australia reveals residents of Western Australia, Queensland, NSW and Victoria who are worried their symptoms may indicate Lyme disease, or Lyme borreliosis, and are seeking advice on which GPs will be openminded enough to order blood tests.

NSW Health describes typical Lyme symptoms as fever, headache, fatigue, sore muscles and joints, and a characteristic skin rash called erythema migrans.

"Although locally acquired Lyme borreliosis cannot be ruled out, there is little evidence that it occurs in Australia," the website says. "While there is little evidence that Lyme disease is caused by Australian ticks, there may be other infections carried by Australian ticks which may cause an infection which is similar to Lyme disease. These infections remain poorly characterised."

In a letter to doctors earlier this month, the Chief Medical Officer, Chris Baggoley, outlined the progress of the committee that will advise him on the evidence for Lyme disease in Australia. He foreshadowed improving the diagnosis process for Australians with Lyme-like symptoms while further research occurs, moves that have been welcomed by Ms McManus, who established a tick awareness foundation in her husband's name.

"Everybody acknowledges that there is a Lyme-like disease in Australia," she says. "We know our ticks carry some kind of pathogen that's making people sick but we don't know what it is, we don't know the causative agent."

As Karl McManus's condition worsened in the years following his tick bite, he was progressively diagnosed with multi-focal motor neuropathy, motorneurone disease and multiple sclerosis despite his family's insistence it was Lyme disease.

He died after catching the flu, when paralysis of his tongue saw him choke on thick mucus.

Ms McManus believes the Baggoley review will lead to recognition of Lyme disease, a view not shared by doctors such as Royal Australian College of General Practitioners spokesman Ronald McCoy, who expresses sympathy for people showing Lyme-like symptoms but believes it is not Lyme disease.

"People are often clutching at straws," Dr McCoy says. "There are no ticks or other bugs in Australia that have ever been identified as carrying Lyme disease."

Lyme Disease Association of Australia president Sharon Whiteman says it is "arrogant" to think Australia wouldn't have Lyme disease and that testing needs to be improved to detect a local strain.

Ms Whiteman, who was bitten by a tick on the Sunshine Coast in 2002, estimates there could be more than 10,000 Australian cases of Lyme disease. "Just a tiny percentage of people have lucked into the information, or kept pushing and found us or found someone who is openminded," she says.

A spokesman for the Australian Medical Association says it adopts a similar position to the RACGP and would not formulate a tick policy or provide advice to members until the Health Department confirms the disease exists here.